The Campaign to Save the North Shore Birth Center

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[The Boston Globe’s coverage of our November campaign to save NSBC was critically helpful. The below message is re-posted from Paul Levy’s blog as a show of support. We do not want to see the Globe go under!]

We have all read recently about the threat of possible closure faced by the Boston Globe. A number of Boston-based bloggers who care about the continued existence of the Globe have banded together in conducting a blog rally. We are simultaneously posting this paragraph to solicit your ideas of steps the Globe could take to improve its financial picture:

We view the Globe as an important community resource, and we think that lots of people in the region agree and might have creative ideas that might help in this situation. So, here’s your chance. Please don’t write with nasty comments and sarcasm: Use this forum for thoughtful and interesting steps you would recommend to the management that would improve readership, enhance the Globe’s community presence, and make money. Who knows, someone here might come up with an idea that will work, or at least help. Thank you.

(P.S. If you have a blog, please feel free to reprint this item and post it. Likewise, if you have a Twitter or Facebook account, please add this url as an update or to your status bar to help us reach more people.)

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UPDATE:

Birth Center to Remain Open, but with Remote Monitoring and Lost Accreditation

Community Challenges Hospital to Do Better

Thanks to the efforts of the Campaign to Save the North Shore Birth Center, on December 15, 2008, the Board of Trustees of the Northeast Health Corporation voted against the proposed closure of the North Shore Birth Center (NSBC). However, as conditions of its continued operation, patients will no longer be permitted to receive the handheld, Doppler-based fetal monitoring that was previously in use at NSBC in accordance with national birth center accreditation guidelines.

Instead, despite their low-risk pregnancies, all NSBC patients will be subjected to remote electronic fetal monitoring (EFM), a practice that leading medical journals agree is ineffective and frequently harmful. Remote EFM will also result in a loss of NSBC’s accreditation by the Commission for the Accreditation of Birth Centers (CABC).  CABC accreditation is a strong indicator of exceptional quality of care, because it ensures the use of practices proven to be safe and effective in a birth center environment.

On December 18, 2008, six representatives of the Campaign to Save the North Shore Birth Center–Nicole Aliberte, Mira Clark, Rebecca Hains, Amy Kreydin, Sarah Shamel, and Christa Terry–met with Dr. Henry Ramini, President and CEO of Northeast Health System, and three other hospital administrators. This meeting had been rescheduled by hospital officials twice, with the result that it did not take place until after the Trustees’ December 15 vote.

At the meeting, Ramini unveiled to Campaign representatives details of the plan to change fetal monitoring practices. These details are highly problematic and deeply troubling to members of the Campaign.

Ramini explained that by the end of March 2009, patients will be monitored electronically for 20 minutes to establish a baseline upon arrival at the birth center. Subsequently, every 30 minutes, another 5- to 10-minute electronic monitoring session will occur. This electronic monitoring will be “continuously transmitted to the hospital,” where it will be remotely monitored by two hospital personnel. Without even observing the patient in question, and despite the well-documented problems of misdiagnosis via electronic fetal monitoring, those personnel  — NOT the midwives — will decide whether the patient should be transferred into the hospital. Ramini added that, in the case of a disagreement, these two “monitors”  would be able to override the midwives’ professional judgment, with a preference toward “erring on the side of overtreating the patient.”

Furthermore, when asked whether patients would be able to opt out of electronic fetal monitoring at the birth center, Dr. Ramini said no, citing fears that if refusal were permitted, all patients would opt out. However, informed refusal is a basic patient right in the state of Massachusetts and a civil right guaranteed by the U.S. Constitution, which protects patients from being subjected to medical procedures without their consent.

The Campaign to Save the North Shore Birth Center decries the hospital’s legally invalid plan to routinely violate patients’ rights.

When Campaign representatives at the meeting cited respected medical studies and reports that detail the unreliability and risks of using electronic fetal monitoring, Ramini said that he “doesn’t know if it’s good or bad for patients,” but that hospital lawyers advise its use purely for legal reasons, so that the hospital could use the monitor printout in case of a lawsuit.   The Campaign representatives provided Ramini with a large binder of evidence-based studies from established medical journals and offered a summary of key points. The evidence we presented details that electronic fetal monitoring is an unacceptable medical practice for low-risk patients, because it often leads to unnecessary and dangerous interventions.  We also offered that electronic fetal monitoring can be used — and has been used, frequently and successfully — against hospitals in lawsuits, making them no less vulnerable to litigation. The attitude of the Beverly Hospital representatives was essentially this: Our minds are made up. Don’t confuse us with the facts.

The Campaign to Save the North Shore Birth Center rejects the hospital’s plan to use remote fetal monitoring. The proposed EFM plans prioritize the hospital lawyers’ exaggerated straw-man fears of a lawsuit over maternal and fetal health and the legal rights of women to accept or reject this questionable intervention.

The Campaign to Save the North Shore Birth Center demands that hospital officials allow the North Shore Birth Center to continue practicing well-established evidence-based care, including the continued practice of bedside, non-remote fetal monitoring by a handheld doppler monitor, which is widely used state-of-the-art equipment.

Our stance may be summarized thus:

1. To subject women and their babies to a form of fetal monitoring known to unnecessarily increase the c-section rate, when a more effective and safer form of fetal monitoring is already in place, is unacceptable.

2. To have medical personnel who are in a separate building hundreds of yards away determine the fate of low-risk women and their healthy babies, overriding the professional judgment of our midwives, is unacceptable.

3. To prioritize legal fears over maternal and fetal health is unacceptable.

4. To violate basic Massachusetts’ patient rights and constitutional rights regarding informed consent and informed refusal is unacceptable.

5. To institute a practice that will cause NSBC, which has held the gold standard of CABC accreditation for years, to lose its accreditation is unacceptable.

HELP US SAVE NSBC!

Here’s what you can do to help save the North Shore Birth Center and its clients from the dangerous and unethical new protocols planned by the hospital:

1. Write letters to Beverly Hospital administrators and its Board of Trustees speaking out against these plans. In our meeting with administrators on December 18, they suggested that members of the community would not be troubled by these plans. They said there has been a change in the culture regarding what patients want, and that because of this context, changes to birth center’s long-standing practices would be acceptable to the community. Let’s flood them with letters again, sending the clear message that they’re wrong!

In addition to the trustees (whose contact information is available here ), please copy your letters to the administrators who attended the December 18 meeting: Dr. Henry Ramini, President and CEO; Chip Peyson, Vice President of External Affairs; Pauline Pike, Chief Operating Officer; and Heather Jones, Director of Community and Public Relations.

2. Send letters to the editor of your local and regional newspapers. Let them know about the Campaign’s continuance and the reasons why we have to keep fighting.

In writing your letters, note that the hospital’s December 15 statement to the media made it sound as though the practice of fetal monitoring would be new to the birth center. (It stated: “The Board recognizes the national trend of birth center closings due to rising costs and has decided to take a proactive approach and modify how care will be delivered at the Birth Center.  Patients delivering at the Birth Center will now receive fetal monitoring during their delivery.”) News articles appearing on this topic have presented this misleading statement as fact. Correct them: Let the media know that fetal monitoring was already in use at the birth center — appropriate bedside fetal monitoring with a handheld Doppler, which, in fact, you most likely experienced at your own NSBC birth — and that you prefer this safer, handheld fetal monitor to the remote electronic fetal monitor that the hospital is forcing NSBC to use, beginning this spring.

Useful tips for writing successful letters to the editor are available here.

3. Contact your legislators, both local and state. Let them know that Beverly Hospital is planning to violate your rights as a patient in the Commonwealth of Massachusetts by denying you informed consent and informed refusal if you give birth at the birth center! Ask them to intervene in any way possible.  Make sure you point out that birth center services using only handheld monitors are far less expensive than hospital services using costly and unnecessary technology. This hospital will have to find the money to pay for these new remote monitors somehow. The extra, unnecessary personnel supervising NSBC births from a separate building will increase costs, as well. Should Massachusetts’ new health plan be further strained by higher costs such as these?

Tips for locating and writing to your legislators may be found here.

4.   Keep your focus where it belongs, on safety. Our interest in maintaining birth center accreditation and appropriate monitoring methods is not because we merely want a “nice experience” at the birth center.  Hospital representatives at the December 18 meeting strongly implied that all the Campaign really cared about was the low-tech, gentler “experience” of birth center birth. This paternalistic, condescending attitude has misread the basis for our concerns and couldn’t be more wrong.  We are intelligent, educated women who understand the difference between real evidence-based safey measure and the hospital’s defensive use of expensive and self-serving unnecessary interventions.

Together, we’ve already won a major battle in the fight to save our birth center. Let’s not stop now–let’s win a reversal of the hospital’s plans to require remote fetal monitoring and violate patients’ rights!

The North Shore Birth Center is in jeopardy!

There is a very serious move to close the North Shore Birth Center, a midwifery practice situated on the campus of Beverly Hospital in Beverly, Massachusetts.

On Tuesday, November 18, 2008, the Board of Trustees of the Northeast Health Corporation considered the proposal to close the Birth Center. During that early-morning meeting, nearly 200 people–adults, children, and babies–bundled up against the cold and held a rally. This rally advocated for the same things as previous efforts, which included a letter-writing campaign, daily picketing, and an open letter to the Board:

  1. A delay of the vote on the Birth Center’s fate, since such an important decision with long-term consequences for our community should not be rushed, and
  2. A meeting between community members and the Board of Trustees, to seek more transparency about the Hospital’s concerns and to open some dialogue that would allow the community–which had thus far felt silenced by hospital administration, which refused to communicate with representatives of our campaign–a real voice in this decision.

Featuring energetic speakers, colorful signs, and lots of cheering, the rally outside of Beverly Hospital made headlines: All the major Boston television stations, newspapers, and radio stations covered the story.

Several hours after the Board of Trustees met, the hospital released the following four-sentence statement.

The Board of Trustees takes its responsibilities to this organization and to the community very seriously.

Consistent with other birth centers around the nation, the North Shore Birth Center is experiencing a significant rise in the cost of malpractice insurance premiums.

The Board of Trustees is diligently weighing the impact that the closure of the Birth Center would have on the community; the level of community interest in its continued operation has not gone unnoticed. The Board intends to leave the Birth Center services unchanged while it continues to examine and discuss this important issue.

In other words, our rally and other efforts were a success! The Board of Trustees recognized the need to move slowly and give the proposal full deliberation.

However, we are not out of the woods yet. As the Boston Globe points out, this statement “ma[kes] it clear that the center’s future is still very much in question.” We still need your help!

Help us save NSBC!

The members of this group are against this proposal and want the Board of Trustees to vote against it. Women deserve to choose the birth experience that is right for them and their families. We ask the Board of Trustees to refrain from making a decision that would deny this choice to families of the North Shore.

NSBC is one of only two birth centers left in the entire state of Massachusetts! Let’s work together to protect it!

ABOUT THE NSBC: Established in 1980, the North Shore Birth Center has facilitated the births of over 6,000 babies to women with “low-risk” pregnancies seeking a natural childbirth. We want the North Shore Birth Center to continue offering quality, compassionate care in an alternative birth setting.

Join the Campaign to help us make our case to the Board of Trustees and hospital administration.

We are now in the process of planning Phase Two of our campaign. We will update this page with information on how you can help as soon as possible. In the meantime, see these links to learn more about our efforts:

Ongoing initiatives:

How to stay informed:

Media coverage:

Blogging coverage:

Please note: The members of the Campaign to Save the North Shore Birth Center are not affiliated with the North Shore Birth Center or Beverly Hospital. We are consumers who care passionately about NSBC!

Last Update: Wednesday, November 21, 9:09 a.m.

Many thanks to Tabitha Sherrell, a professional photographer and Campaign member who documented our rally today! She posted several great shots on her blog this afternoon. They’re fantastic! Check them out here.

The American Association of Birth Centers (AABC) has passed along this great letter [PDF] they’ve sent to the Northeast Health Corporation’s Board of Trustees, in support of NSBC.

A big THANK YOU to AABC for advocating on behalf of all of us!picture-9picture-10picture-11

We have some great plans leading up to the November 18 Board of Trustees meeting. Please consider helping our cause by serving as a volunteer coordinator for one of the following areas:

  • Poster making
  • Flyer distribution
  • Picketing efforts
  • The Nov. 18 rally

Volunteer coordinators would need to be available by phone and email to guide the efforts of those volunteering to execute the above tasks.

To learn more, please email us at SaveTheNorthShoreBirthCenter AT gmail DOT com. Thanks!

Stacy writes:

A small group of us are getting together to write our letters. My hope is it will be motivating and inspirational. The North Shore Birth Center has touched all our lives. The midwives need us. Please join us!

WHEN: Sunday November 9th at 1:00 p.m.

WHERE: the Parish House adjoining the Orthodox Congregational Church of Lanesville. 1120 Washington St. in Gloucester.

INFO: Please e-mail me with questions, concerns and/or suggestions. salstacy AT hotmail DOT com


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