On August 12th, Health and Hospitals Corporation closed the Labor and Delivery service of North Central Bronx Hospital, saying that pregnant women would now use the service at Jacobi Medical Center. But Jacobi already has an overstretched labor and delivery service, raising concerns about women’s access to safe and respectful maternity services for women in the Bronx.
For over 20 years, North Central Bronx Hospital had a national model of excellence in maternity care provided by nurse midwives. In 2002, the program received the American College of Nurse Midwives’ award called With Women for a Lifetime for innovative and compassionate midwifery care practices. But beginning in 2009, this successful model was undermined as services were dramatically cut back, midwives were laid off and the midwifery model of continuity of care was completely disrupted. According to Choices in Childbirth, this resulted in a 90% increase in Cesarean sections between 2008 when it had the lowest rate in the city at 15.9% and 2012, when the rate had doubled to 30%. The benchmark set by the WHO is 15%.
As a nation, the U.S. outspends other nations on maternity care, largely because of this high Cesarean section rate and the cost of delivering in hospitals rather than childbirthing centers. And it continues to perform poorly in the ranking of developed nations on outcomes such as maternal mortality and infant mortality. Overwhelming evidence supports a midwifery model of care as the way to achieve excellent clinical outcomes while reducing the cost of maternity care.
So why isn’t the city–and the nation–moving in this direction? Tonight on Healthstyles, producer and moderator Diana Mason, RN, PhD, discusses this question with Elan McAllister, the founder and executive director of Choices in Childbirth, a non-profit organization that is a national leader in consumer advocacy and outreach for women and their families; and Nan Strauss, an independent researcher and consultant on maternal health issues who was formerly with Amnesty International USA and authored its report, Deadly Delivery: The Maternal Health Care Crisis in the USA.
Healthstyles if brought to you by the Center for Health, Media & Policy at Hunter College, City University of New York.