State hears testimony on closure of Holyoke Medical Center’s birthing center

  • Holyoke Medical Center GAZETTE FILE PHOTO

Staff Writer
Published: 7/29/2020 6:56:15 PM

HOLYOKE — When Jane Frey began working as a midwife in Holyoke in 1985, the city’s infant mortality rate was the highest in the state.

As part of the Holyoke Infant Mortality Task Force, Frey and others worked with the Department of Public Health, or DPH, to take steps that significantly lowered that mortality rate. However, after Holyoke Medical Center recently announced that it intends to close its Birthing Center by Oct. 1, Frey is concerned that history might repeat itself.

“I fear we are back to the beginning,” Frey said Tuesday, speaking in front of the same state agency whose work with the task force led to the creation of the midwife practice at Holyoke Medical Center.

Frey’s comments came at a DPH hearing mandated as part of an essential service closure process that hospitals must complete before closing a unit. Holyoke Medical Center announced on May 29 that it planned to shutter its 13-bed obstetrics unit and 10-bassinet infant nursery — services it had already “temporarily” ended in early April when it agreed to house patients from the Holyoke Soldiers’ Home during a massive coronavirus outbreak at that facility.

Beginning the hearing, HMC CEO Spiros Hatiras said that the medical center had previously closed birthing services in 1974 due to a low volume of births and that it only re-opened in 1993 because the hospital had lost contracts with two HMOs that insisted hospitals provide birthing services.

“It was widely acknowledged that the reopening would be a risky move and would be unpopular with other providers in the area because there was no unmet need in the community for birthing services,” Hatiras said.

Hatiras said that birthing volume has been below the hospital’s target for nearly three decades and that a low volume does not allow providers to maintain their professional competencies. Hatiras also said the hospital has not received reports that patients, who are now being sent to Mercy Medical Center in Springfield, have had issues with accessing birthing services since the unit closed in April.

“Holyoke Medical Center is only discontinuing birthing services at our facility, not all maternal services,” Hatiras said. “We have been and will continue to provide prenatal services, family planning services, GYN services and postpartum care.”

Hatiras said the hospital has a transportation system for patients. He also said the hospital will continue to provide education, care and support for mothers and babies before and after birth, which he said are the most important factors for keeping infant mortality low.

Many speakers during the public hearing, however, expressed outrage over the decision to close the Birthing Center, the way the closure was handled and the effects they said it would have on the community.

“I urge Mr. Hatiras and (head of women’s services Marc) Zerbe to walk the two-mile climb from the Flats of Holyoke to the OB-GYN offices at Holyoke Medical Center, pushing a baby carriage or with other children in tow to see what it is like if you had no transportation,” Frey said.

Frey added that when she recently called HMC to inquire about prenatal care, she was told there were only two OB-GYNs and one nurse midwife on staff, none of whom speak Spanish. She also said she was told obstetric care would be provided at HMC and that deliveries will be done at Mercy — with providers patients have not met, she noted.

Many took issue with the way they said Birthing Center staffers were treated, which they said pointed to a systemic and intentional dismantling of midwifery and birthing services.

“If the hospital had these concerns, never once did they truly share them with us, the people on the front lines,” said Nina Kleinberg, a nurse midwife who worked at the practice from 1988 until 2019. “Instead, they created a toxic atmosphere that made us want to leave, and that’s why I don’t trust their rationale.”

Kleinberg was one of five former employees who spoke on the record for a Gazette investigation into the closure. The five women alleged that higher-ups engaged in bullying, intimidation and micromanagement of midwives and other staffers, pushing out many longtime employees in the process.

“Despite what is being stated as low numbers, actually for our community hospital we were doing quite well and maintaining our numbers despite a plummeting birth rate in the nation as well as in the state of Massachusetts,” said former HMC nurse midwife Vanessa Ross, who worked at the practice from 2006 until 2019. “That administration systematically brought about the low numbers that you now see.”

Ross and former nurse Lisa Pack Kirschenbaum, who worked at the Birthing Center for 26 years, challenged the assertion that a lower volume of births led staff to be less prepared for emergencies.

During his testimony, HMC Chief Medical Officer Simon Ahtaridis said that a low volume also meant the hospital only kept a small number of physicians on staff, which he said caused problems if somebody took time off for any reason.

“Our patients and providers deserve better for that, and in partnering with Mercy our remaining two physicians will be able to join the Mercy team of nine physicians and provide more sustainable and stable coverage for urgencies and emergencies,” Ahtaridis said.

For many speaking Tuesday, the closure of the Birthing Center represented a larger problem with health care in the region and country.

“My concern is that the public health of individuals of our community, particularly in Holyoke, it’s always been considered due to revenue,” said Ward 1 City Councilor Gladys Lebron-Martinez.

Patricia Duffy, who is running for the city’s state representative seat, said city residents expressed concern that local control or other services may be lost at the hospital. Current state Rep. Aaron Vega, D-Holyoke, expressed frustration with a system that he said leaves the community hospital reliant on “care packages from the federal government and last-minute bailouts by MassHealth” to keep it afloat.

DPH now has 15 days to determine whether the services being closed are “necessary for preserving access and health status within the hospital’s service area.” If deemed necessary, the hospital will have 15 days to submit a plan for assuring access.

However, that is the extent of the powers DPH has under state law. The state has no power to stop the closure or penalize the hospital for closing services, even if they are deemed essential. State Rep. Lindsay Sabadosa, D-Northampton, noted that fact in her comments Tuesday.

“We see consistently programs taken apart piece by piece until they are no longer deemed essential, and that seems to happen more often than not in poor communities, it happens in communities of people of color and it seems to be real easy when women are involved,” she said. “And that is something that DPH along with the Legislature really is going to need to take a hard look at.”

Dusty Christensen can be reached at dchristensen@gazettenet.com.


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