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Ascension eliminates midwives on staff at Providence Hospital

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Doctors say the current legal limbo surrounding abortion in Michigan couldn't have come at a worse time: patients are flooding in from other states. Now, some doctors are asking them to make plans elsewhere.

A major Metro Detroit hospital has announced that it will no longer keep midwives on staff.

Ascension Health says that as of March 1, midwives will no longer staff the Alternative Birthing Center at Providence Southfield Hospital. Historically, midwives have supervised most of the births there, according to birth workers.

In a letter to patients dated January 31, Ascension says that all deliveries at Providence will be supervised by “highly qualified obstetric physicians who specialize in low-intervention births.”

The move has outraged Michigan’s midwifery and birthing communities. They say there’s overwhelming evidence that midwives provide the highest level of patient care, and have better birth outcomes in low-risk pregnancies.

Ruth Zielinski, a certified nurse-midwife and University of Michigan nursing professor, said midwives have higher rates of patient satisfaction, lower caesarean section rates, and lower rates of episiotomy and other birth interventions that can raise risks for mothers and babies.

Zielinski said physicians can be valuable members of a birth team, especially with higher-risk pregnancies. “But when you're using OB-GYNs for straightforward births, it's a vast overutilization of training,” she said.

Ascension did not provide a rationale for its decision, and did not respond to a follow-up request for comment. Zielinski said offloading all births to Providence physicians may make sense from a short-term cost-cutting perspective, but it’s ultimately not a good solution.

“It’s on that model where physicians can just see as many patients, and they can run from room to room for the births,” she said. “Whereas midwives will spend more time during the pregnancy and during the birth in the patients’ rooms and still cost less money.

But you're not going to fire the physicians because you need the physicians, so you fire the midwives. It just seems easy. And it's of course very shortsighted.”

Ascension told existing patients that it will help them transfer to another health facility if they want a midwife birth. According to a statement provided to WXYZ-TV, the health system said that any patients who want to use a private certified nurse-midwife can do so, so long as the midwife has admitting privileges at Providence.

Ascension is taking us backward,” said Jessica English, a doula and birth educator based in Kalamazoo. She said that while some hospitals have been expanding midwifery programs due to burgeoning demand, Ascension is cutting back.

Last year, Ascension announced that it would cut its midwife staff at Kalamazoo’s Borgess Hospital. English said that as of now, she’s only aware of one midwife operating at Borgess.

One of the great things about midwives is they tend to provide very personalized care, and that's definitely much less available when you have obstetricians who are seeing many, many more clients,” English said.

“It's a shame to see this happening. Parents want evidence-based, respectful care, and Ascension is eliminating a great option to receive that.”

Ascension has also made recent moves to reduce or eliminate maternity care at some of its Michigan hospitals, part of a larger national trend.In just the past year, the health system announced that it would end maternity care at Ascension Macomb-Oakland in Warren, and at Ascension River District in East China Township. In both cases, the company said it made more sense to consolidate birthing services at its other regional hospital.

A rally to support Providence midwives is planned for Sunday at the hospital’s Alternative Birthing Center.

Sarah Cwiek joined Michigan Public in October 2009. As our Detroit reporter, she is helping us expand our coverage of the economy, politics, and culture in and around the city of Detroit.
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