Credit: Jim.henderson on Wikipedia, under Creative Commons
NEW YORK (WOMENSENEWS)--The clock is ticking for a well-regarded maternity ward in the borough with the highest risk of dying in childbirth.
The New York State Department of Health said in an email interview that if labor and delivery services are not restarted at North Central Bronx Hospital by April 30, 2014, the hospital will have to decertify its maternity and neonatal beds and services from its operating certificate.
The maternity ward was abruptly suspended last August amid concerns over the ward's shortage of senior doctors to serve women in the community, many of who are low-income, minorities or immigrants.
Now community health advocates say they are being kept in the dark by the Health and Hospitals Corporation (HHC), which runs public hospitals in New York, about what will happen next.
"HHC is not being open or transparent about its process for reopening this vital service," said Eileen Markey, a member of Community Power North Bronx, a coalition of local residents that works toward improving living and working conditions of the neighborhood's residents. "This is gravely disappointing as with every week that passes pregnant women in our neighborhood are forced to find other places to give birth, putting them at a disservice and eroding support for North Central. We do not have confidence that HHC is putting sufficient effort and urgency into reopening this vital service."
Meanwhile, Markey worries that an award-winning midwife program that served women in the community for 30 years, until it was drastically cut back in 2009, will be very difficult to ever bring back.
"The midwife model was brilliant," she said. "It served women better and it resulted in an admirably low rate of C-sections. It is with great dismay that we read between the lines to see HHC shifting to a physician-led labor and delivery unit from the midwife model of care."
Activists have reason to be concerned. In the background of this particular crisis, questions hang over public hospital funding both in New York and the nation.
As part of the New York State budget-setting process, Gov. Andrew Cuomo recently expressed frustration over the 18 month wait for the Centers for Disease Control and Prevention to approve the state's Medicaid waiver, which would reallocate $10 billion in federal health care funding. Without this money, restructuring failing hospitals such as Long Island College Hospital and Interfaith Hospital will not be possible.
Across the country, public hospitals are closing at disproportionate rates in comparison to private hospitals, according to a report by the State University of New York Downstate Medical Center.
Last August, North Central Bronx Hospital gave just three days notice that it would be suspending maternity services, and North Central's staff and patients were transferred to Jacobi Hospital nearly four miles away, leading to overcrowding. Community backlash prompted HHC in November to announce plans to reopen labor and delivery services.
At first the suspension was only supposed to last until Dec. 9, but HHC won an extension until April 30, according to a spokesperson from the Department of Health, so the new chair of the maternity department would have enough time to recruit doctors. Nurses were transferred to Jacobi and it's unclear if they will return to North Central.
Unions and community activists say that since announcing plans to reopen maternity services, HHC has been tight-lipped, leaving them out of the reopening process in the same way they were excluded from the abrupt decision to suspend the ward.
"We want the best for this hospital," said Dr. Frank Proscia of Doctor's Council, which represents doctors working in hospitals. "There are multiple fractures in the entire obstetrics/gynecology department because the labor and delivery services have been suspended."
When the topic of involving the community came up at a press conference last December, an HHC spokesperson said it would try to organize at least one meeting, which health care leaders and union organizers feel won't be enough.
Community leaders and health care activists feel uncertain that the hospital will be able to reopen in time.
The announcement that the hospital needs to reopen by April 30 to hang on to its certification was made only five minutes before the end of a community meeting on Dec. 12.
Only two representatives from HHC were present at the meeting – LaRay Brown, senior vice president of corporate planning, and Sheldon McLeod, chief operating officer at North Central Bronx. The new chair of the maternity ward, Michael Zinaman, was not present.
"The chairman not being at the meeting says a lot," Doctor's Council's Proscia said. "He is supposed to be responsible for coming up with a plan for returning maternity services, yet HHC leadership has been making all of the decisions."
At the meeting, questions were raised about the maternity unit being fully restored and the reinstatement of the award-winning midwife program that was removed in 2009. So far, neither of these questions has been answered.
"Community Power North Bronx's demands remain the same as when the labor and delivery was taken from us in August," Markey said. "We want significant and sustained community input into how the department addresses the needs of our neighborhood."
Crystal Lewis is the Women's eNews correspondent covering U.S. maternal health. You can follow her on Twitter @CSamariaL. This story is part of a reporting grant from the Fund for Investigative Journalism on African American maternal health in New York City and is also part of a larger project on African American maternal and infant health nationwide funded by the W.K. Kellogg Foundation.
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