Massachusetts Nurses Association Statement In Opposition to Proposed Closing of the Birthing Center at Leominster Hospital by UMass Memorial Health

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May 30, 2023, 10:41 ET

Nurses believe the decision by UMass Memorial Health to close this vital service will jeopardize the health and safety of mothers and newborns in the Greater Leominster and Fitchburg Communities

Nurses are not alone in their position as local, state and federal policymakers have scheduled a protest opposing the closing outside the facility on Tuesday, May 30 at 6 p.m.

LEOMINSTER, Mass., May 30, 2023 /PRNewswire/ -- UMass Memorial Health, the largest health system in Central Massachusetts, has recently announced its intention to close the Birthing Center located at UMass Memorial HealthAlliance-Clinton Hospital's Leominster Campus, a program that serves as the primary maternity program for residents throughout the communities of Greater Leominster and Fitchburg.

In the last decade, we have seen the loss of no less than 10 such maternity unit closures, each of which was evaluated by the Department of Public Health and subsequently deemed essential to preserving the health of those communities. Above is a map detailing those closures.

The Massachusetts Nurses Association (MNA), which represents nurses who work on the Leominster campus, as well as thousands of nurses within the UMass Memorial Health system, strongly oppose the closure and view it as a callous and unnecessary decision that will jeopardize the health and safety of mothers and newborns of the Northern Central Mass. region, resulting in mothers being forced to deliver babies in overcrowded hospital emergency departments, or worse, on the side of highways leading to faraway maternity services.

"The nurses of Leominster Hospital are outraged by this announcement, as it shows a blatant disregard for our patients and our region," said Miko Nakagawa, RN, a nurse at Leominster Hospital and co-chair of the nurses local bargaining unit with the MNA. "There is no medical or moral justification for this decision, which will have a devastating impact on families, particularly economically disadvantaged residents who lack the ability to travel long distances to receive care in Worcester or Gardner."

"I am honestly shocked that they want to try and close this service," said Amy Gagnon, a maternity nurse who has worked in the Birthing Center for the last 12 years, including a long and exhaustive shift over the weekend, "The last two nights alone, we had three deliveries, where are these people supposed to go? These are not just patients to us, they are members of our community. They are our friends and neighbors. We have families who know us and trust us as we have delivered all of their children. There are families who lack the means to travel long distances for the care we provide. I hate to think of what will happen to these folks if they are allowed to close the center."

"As a native of this region both my husband and I were born at this hospital, and as a mother who gave birth to my two children here, I consider it an honor and a privilege to be there for the families we care for every day at what is the most exciting and life-changing moments of their lives," explained Tara Corey, RN, a nurse at Leominster Hospital for the last eight years, with the last three working in the Birthing Center. "I am both saddened and alarmed that our employer wants to strip this community of this service, and the impact this will have on our patients. I would never want to abandon my patients at this critical time in their lives, and I can't understand why UMass would want to do that to this community."

Nurses in the hospital's emergency department are also concerned about their ability to care for mothers and newborns without the Birthing Center. "We struggle now with our emergency department staff to care for our current patient population, and it can take hours to find ambulances to transport patients who need to go to other hospitals. Under these conditions, I don't see how we could safely manage a mother and baby without the specialized skills and experience of our labor and delivery staff. It's downright scary," said Samantha Rahaim, RN, a nurse in the hospital's busy emergency department.

The Leominster nurses also take issue with the hospital's rationale for closing the service, where UMass claims it is due to staffing shortages. The nurses are clear that whatever problems that exist with staffing the unit are by design, as hospital management for years has understaffed the hospital as a means of increasing revenue at the expense of patient care. Over the years, the MNA has filed dozens of grievances with management over their failure to recruit appropriate staff in all areas of the hospital, including the maternity unit.

As Gagnon explained, "They have been purposely withholding jobs for over a year to claim they have no staffing when we have documentation of experienced nurses being told that there were no jobs or that jobs were frozen. I have been fighting with upper management for over a year to get these nurses hired and trained, it's all part of their plan to streamline services to drive patients to Worcester and not what is best for the community."

UMass's strategy is well known by the MNA, as its members have watched hospital systems across the state purposefully starve services so that they can later claim the service is no longer viable and must be closed.

Nurses Not Alone in Their Opposition to Closing, Community Members Voice Similar Concerns

Following the announcement by UMass Memorial Health, nurses learned that they are not alone in their opposition to the closing, as residents, community advocates and policymakers have all raised serious concerns about the decision and its impact on the community. This includes members of the Joint Coalition on Health (JCOH), a prominent volunteer-led, grassroots coalition of community members and advocates formed in 1998 to address social determinants of health, and to pursue actions to address the health needs of the residents of Northern Worcester County.

"If there was ever a time that we need to come together as a community and fight, this is it," said Eladia Romero, a Leominster resident. "This is personal for me. Nine years ago, I delivered my son via emergency c-section at Leominster Hospital and then we were rushed to the UMASS NICU to save his life. Had I been forced to drive to Worcester that day my son would not be here today. We must stand together and do all we can to stop this closure."

"As a longtime resident of Fitchburg and a community advocate for the region, I'm incredibly frustrated that we are seeing hospital services contract at a time when we desperately need them to expand," said Tara Rivera, a resident of Fitchburg and JCOH member. "UMASS has decided that people, many of whom are living in poverty, should travel even further for services. This seems immoral. Also, as a woman with an MBA, frankly, the numbers just don't add up. How can hospital leadership continue to reward themselves so lavishly while claiming to be running in the red? If it's about stigma against poor communities, then it's ethically abhorrent. If it's poor management, then the UMass Board of Directors needs to revisit their obligation to place the needs of the community first and consider replacing management."

"I can't think of a more vulnerable population than pregnant women and newborns. Health disparities start before we are even born, and this is an example of how. In addition to how much money they have, it seems that the unspoken criteria for closure is the impacted people's ability to fight back. We are taking services from babies now- they literally cannot speak for themselves. If we are going to continue to allow hospitals to run as businesses, cutting services that aren't making money, paying themselves seven figure salaries and not being accountable to the communities they serve, the next generation will pay the price," stated Amy Ebbeson, LCSW, a resident of Rutland and Clinical Director for Worcester Addresses Childhood Trauma.

"The news of this closure feels like a knife in the back of our community. Especially for our poor and BIPOC community. We all know that these are the people who will suffer most. My own daughter gave birth at Leominster and barely survived the delivery. If she had needed to travel to Worcester, it is likely she would have died," said Irene Hernandez, a member of the Pocasset Wampanoag Tribe of the Pokanoket Nation and community advocate. "We hear hospitals talking about equity. We see them hiring DEI consultants and managers. But at the end of the day, decisions such as this reveal the truth about commitment to equity. Will UMass prioritize executive pay over the lives of historically, marginalized communities? Or will they live up to their oath 'to do no harm'?"

Closure of Maternity Services Follows Dangerous Trend for Commonwealth

According to a White Paper on maternal services in Massachusetts published by MNA's Congress on Nursing Practice, the decision by UMass to close this service follows a trend by other healthcare corporations in the state to close vital community-based programs and services as a means of funneling their patients to larger and more profitable major medical centers. Maternity services have been a specific target for these closures, creating what the March of Dimes has characterized as "maternity deserts", meaning regions where residents lack appropriate access to needed maternity care, particularly for those serving poorer communities and people of color. In fact, last year a Special Legislative Commission on Racial Inequalities in Maternal Health in Massachusetts issued a report that highlighted how racial minorities are negatively impacted by inequitable policies and practices, including the lack of access to appropriate maternal care.

Leominster and Fitchburg have been characterized as Gateway Cities, moderately-sized urban centers subject to economic challenges, and issues of inequity, particularly for people of color and low economic means, the very populations to be placed most at risk by the closure of the Birthing Center.

According to the Centers for Disease Control and Prevention (CDC), approximately 700 women die each year in the United States from pregnancy-related complications. Approximately 3 in 5 of these pregnancy-related deaths are preventable. Non-Hispanic Black women are 3.3 times likely to die from a pregnancy-related cause compared to non-Hispanic white women. Another 50,000 women a year have severe pregnancy complications or severe maternal morbidity. Researchers have identified factors that contribute to pregnancy-related deaths including limited access to transportation; health facility factors such as lack of appropriate personnel or services; provider factors such as lack of continuity of care; and system-level factors including access to care.

"Once again, we are as a community in the position of begging for the basic services that our tax dollars fund. It feels like a never-ending barrage of insult to injury with no accountability in the face of continued cost to the community and the degradation of the quality of care and health outcomes," said Susan Buchholz, who is a resident of Ashburnham, member of JCOH and a Bloomberg Johns Hopkins MPH Fellow. "We need state leadership to step in and hold nonprofit hospitals accountable. Existing safeguards via the Attorney General's office and DPH, although well intended, are not working and need a massive overhaul. There is so much wisdom in the community but the loudest voice in the room is always coming directly from the C suite."

As the community comes together in opposition, the state legislative delegation is taking action with the scheduling of a protest outside the hospital on Tuesday, May 30 at 6 p.m.

Under state law the hospital must provide 120 days' notice of its intent to close a service and the Department of Public Health is required to hold a public hearing to allow the community and other stakeholders to voice their concerns about the closure. In the coming weeks the MNA intends to work with members of the community, local, state and federal officials and other advocates to mobilize broad based opposition to the closure in the hopes of convincing the leadership of UMass Memorial Health to preserve this vital service.

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Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 25,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on healthcare issues affecting nurses and the public.

SOURCE Massachusetts Nurses Association