Worcester Business Journal

12 Worcester Business Journal | August 21, 2023 | wbjournal.com e high cost of delivering babies e saga over the proposed closure of the Leominster maternity center is part of a national struggle beset by doctor shortages, rising maternal morbidity, and money-losing operations BY EMILY MICUCCI Special to WBJ F or five years, UMass Memorial Health has attempted to grow the obstetrical practice that, until now, has provided prenatal care and labor and delivery services to women in North Central Massachusetts, said Dr. Eric Dickson, president and CEO of the region's largest healthcare system, based in Worcester. "It was never a program that was rock solid," Dickson said. Dickson said the goal was to invest in the program and grow it to a more viable 1,000 deliveries per year at UMass Memorial HealthAlliance-Clinton Hospital in Leominster, but the number of babies born in the city went down and not up, lately hovering around 500, which translates to an average of 1.5 births per day. at may be due in part to a national downward trend in births during the COVID-19 pandemic, though the trend preceded 2020. Now, the region's largest healthcare system is turning in another direction to provide care to pregnant women now treated in Leominster: Providing some outpatient OB-GYN care in Leominster but sending women in labor to UMass Memorial Medical Center in Worcester to deliver. On May 30, UMass Memorial officials announced the planned closure of the HealthAlliance labor and delivery unit, pending a public comment period and review by the Massachusetts Department of Public Health. It's unusual for DPH to stop a hospital from closing a program, but DPH deemed the unit an essential service on Aug. 9 and is requiring UMass Memorial to provide detailed plans about how it will assure access to inpatient maternity care to patients in the region by Aug. 23. DPH's ruling is stronger than others when hospitals announce plans to close services, amounting to a grilling of UMass Memorial, said David Schildmeier, spokesman for the Massachusetts Nurses Association labor union. "It's really clear that they have concerns," Schildmeier said. But to Dickson and other leaders at UMass Memorial, including Dr. Tiffany Moore Simas, chair of obstetrics and gynecology for the system, the planned change marks an improvement in care for women in North Central Massachusetts. Simas was the first to raise a concern about the safety of labor and delivery at HealthAlliance, Dickson said. ere is just one OB-GYN le on staff, and another works on a contract basis, along with a midwife at the hospital. e capabilities of the Worcester labor and delivery unit far exceed those offered at a small community hospital like HealthAlliance, Dickson said. For example, if someone arrives in the middle of the night for an emergency Cesarean section, oen a doctor has to be called to come in to work, something larger hospitals don't contend with. e Leominster hospital has no neonatal intensive care unit. e capacity in Worcester is greater because the maternity unit was built at a time when birth rates were higher, Dickson said. Meanwhile, a large coalition of local and state elected officials and other stakeholders aren't buying it. Emotions ran high during a lengthy hearing in July, during which some people angrily called out Dickson and other hospital officials, saying low- income and patients of color will be hurt the most by the decision to relocate labor and delivery care 30 or more minutes south of Leominster. Underscoring their point was a scathing report by DPH on July 12, detailing a large increase in severe maternal morbidity – essentially, life-threatening events for mothers giving birth – in the last 10 years in Massachusetts. is speaks to a national trend toward worsening outcomes in childbearing in the U.S., which is considered by many to be a scandal in a country that spends the most money on health care and boasts the best medical technology in the world. Nationally, as here in Massachusetts, Black and Latino mothers are those who face the highest risk of severe Dr. Eric Dickson, CEO and president, UMass Memorial Health IMAGE | ADOBESTOCK.COM 0 100 200 300 400 500 600 700 FY '18 FY '19 FY '20 FY '21 FY '22 FY '23 thru March FY '23 Projected 678 569 557 572 511 230 460 HealthAlliance- Clinton Hospital deliveries Source: UMass Memorial Health

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