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Midwives at Bellevue Stop Providing 24/7 Care for First Time in 2 Decades

By Amy Zimmer | June 7, 2017 3:11pm
 A pregnant woman getting her belly measured as part of her prenatal care.
A pregnant woman getting her belly measured as part of her prenatal care.
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MANHATTAN — For the first time in its 25-year history, midwives at Bellevue Hospital are no longer providing 24/7 care to their patients, officials told DNAinfo New York.

Effective May 29, the hospital — whose official name is now NYC Health + Hospitals/Bellevue — officially stopped offering round-the-clock coverage by their midwifery program, a hospital spokesman confirmed.

That marks a departure from the program's longtime mission to ensure that someone from their team would be with patients for all visits around the clock.

It could also be a bellwether for the direction that other city hospitals will follow amid the system's plans for a major restructuring that could reportedly result in up to 600 layoffs, experts fear.

“If you can’t tell your patients that I or one of our colleagues can guarantee being at your birth than it’s not true midwifery,” said midwife Abby Brown, who worked at Bellevue from 2007 until she left earlier this year to start her own practice with another ex-Bellevue midwife at Mount Sinai West.

“Midwives are getting shut out of [H+H], and it’s shortchanging the most vulnerable women in our city. We have better maternal and child outcomes, and we give the best care to low-risk women,” she added.

The only time the hospital previously couldn't offer midwife coverage was when it was closed during Hurricane Sandy, Brown said.

When Brown started at Bellevue, there were 12 midwives on staff — compared to the current seven — and the hospital had a natural birth center that drew patients from all over the city.

The birth center, however, closed in 2009, reportedly because of financial pressures and declining birth rates. The space has since sat vacant, used for storage for the hospital’s Neonatal Intensive Care Unit, midwives said.

The midwife staff attrition and the hospital's unwillingness to rehire for the positions means residents and physicians are increasingly filling in at births — despite having no prior contact with the mothers whose babies they're delivering, midwives added.

Gina Eichenbaum-Pikser, who left Bellevue in the fall to start Community Midwifery Care with Brown, said the midwife program is crucial because it serves the largely immigrant and undocumented Bellevue patient body.

“[Hospital officials] don’t understand there’s a difference between the residents, the midwives and the OBs,” Eichenbaum-Pikser said. “To them, a pair of hands to deliver a baby is a pair of hands to deliver a baby.”

“The attitude in the public hospital systems is ‘You’re getting free care. You should be grateful and take whatever we give,’” Eichenbaum-Pikser said. “That’s a tragedy for those midwives and the women they take care of. A midwifery service without continuity of care is a severely disabled service. The heart of midwifery care: it’s about the relationship between the midwife and patient. It’s about the trust. And that’s why midwives have such good outcomes.”

More than 2,200 people have signed a MoveOn.org petition, launched by NYC Midwives, a chapter of the New York State Association of Licensed Midwives, to urge the city to keep midwives at Bellevue.

“We’re following the exact same standards as OBs, but there’s a quality of involving the woman actively in her care — having her questions respected, spending the time to present options and being an ally in a giant, unfriendly hospital system,” said Laura Zeidenstein, program director for nurse-midwifery at Columbia University’s School of Nursing and co-chair of NYC Midwives.

Zeidenstein added that midwives are more affordable, less invasive and have better outcomes than their physician counterparts.

“Midwives have a much lower C-section rate, use interventions less or when they’re more necessary and focus a lot on education — making more informed choices — that carries over into a women’s home life, family life and community,” she said.

The city tried to cut the midwifery program four years ago at North Central Bronx Hospital, but the community rallied to reopen it.

Hospital officials said there is no concerted effort to reduce midwifery services and added that midwives continue to be available at Bellevue every day during the week.

However, Bellevue's needs have changed with fewer births overall and more complex, high-risk deliveries, officials said.

“Midwives are important members of our labor and delivery teams, and we are committed to offering this option for new mothers and families," a spokesman for H+H said.