Reductions in maternal health services have sparked protests

“As we look around at the other challenges facing reproductive choice … and the time against the national landscape, it seems so troubling,” she said.

As the nation awaits a Supreme Court ruling on the future of abortion rights, patient advocates are furious that in addition to the impending closure of the maternity ward, Massachusetts lawmakers recently sent several proposals to the Legislative Cemetery to expand access to maternal health services. .

Some of the proposals, advocates said, would help reduce the large racial gap in maternal deaths, which are nearly three times higher among black women nationwide than among white women. In Massachusetts, state data shows that black women are about twice as likely to die during pregnancy or within a year of giving birth as white women.

Seven hospitals in the last 12 years maternity wards have been closed across the state, including three in the last three years in Southeast Massachusetts, according to the Massachusetts Nurses Association.

The North Shore Birth Center, an exhausting villa on Beverly Hospital, offers women with low to moderate risk of pregnancy the opportunity to give birth to their babies without drugs to induce birth and control pain, or machines to monitor the process.

Data from Beth Israel Lahey Health show that while births at Beverly Hospital have declined slightly over the past three fiscal years, births at the maternity center have actually increased.

“Beverly Hospital is committed to providing the full range of health services for women and will continue to provide an exceptional birth experience,” said Dr Mark Gendro, the hospital’s chief physician, in a statement.

Gendro said that although the maternity center is closing, the hospital will provide care for midwives, who are usually more practical and are a hallmark of the maternity center. Certified midwives are nurses with additional training in obstetrics and practice primarily in hospitals rather than maternity centers or home delivery.

Another group, known as certified midwives, does not have nurses, but is trained and accredited by the same national organization that accredits midwives. These midwives specialize in outpatient births and newborn care. Thirty-seven states, including Maine, Vermont and New Hampshire, license professional midwives, but not Massachusetts.

A proposal that fails in the legislature would create a formal process for licensing and regulating certified professional midwives. This will allow them to administer life-saving drugs, such as drugs to stop bleeding, and will include those midwives such as MassHealth [Medicaid] providers.

Proponents say it will significantly increase access to midwives for low-income families and colorful women, as 40 percent of Massachusetts births are paid for through MassHealth. Proponents also say that women of color often find their health preferences for a short time, but midwives tend to be more careful about patients’ choices.

Tiffany Wasel, at her home with her daughter Amelia, 10. She is a registered nurse and says that women, and especially colored women, often have their health preferences during pregnancy and childbirth by deviating.
Susanne Kraiter / Globe Team

“As a black nurse, I’ve seen many things I wonder about, such as why this man got painkillers and not this man?” Said Tiffany Wassel, a registered Matapan nurse who works at a hospital and is expecting her second child next. month.

After a painful experience giving birth to her first child in a hospital, where she said she had to beg for more time to give birth to her daughter naturally, without medication to speed up the process, she planned a home birth with a midwife.

“It’s so important to give people these opportunities and standards, because home births are going to happen,” she said.

State and national data show that home births increased in the first year of the pandemic, rising by 47 percent from 2019 to 2020. Nationally, this figure rose by 36 percent among black women.

“Black women are returning to home birth because they see it as a control over their bodies and babies,” Wassel said. “You can see how many black women die during pregnancy and childbirth, why can’t we fix that?”

Two recent reports, including one by an expert group commissioned by state lawmakers, concluded that increased access to maternity and other maternal health services could reduce maternal deaths among people of color and reduce healthcare costs.

Susan Hernandez, a certified midwife nurse who works at a health center in Chelsea, serves on this state panel. She supports the proposal to create a path for licensed midwives who are not nurses, as this will provide more assurance that patients receive quality care.

“They have met the national certification standard, but Massachusetts does not license and regulate them, so you will know that your professional midwife meets the national standard,” Hernandez said.

“As it stands now, anyone can hang shingles and say she’s a midwife.

Another proposal killed by state lawmakers would require midwives to receive the same insurance indemnity as doctors for the same services.

Right now, Hernandez said, they are recovering about 15 percent less. Midwives usually employ midwives, which means that they are not as financially competitive as maternity hospitals, which limits their ability to offer more services.

“I am not 85% responsible for the results for the mother and baby and they do not give me an 85% discount on equipment and rent,” said Hernandez.

U.S. Sen. Becca Rausch, a Democrat from Needham and co-sponsor of the bill that would create licensed professional midwives, said it was unclear why fellow lawmakers sent her proposal and other expanding maternal health services for further study, which in practice kills him for this session. Several of the bills, including hers, have received favorable reports from legislative committees in previous years before they were killed.

“This is a meaningful, real solution, which to a large extent has few or no shortcomings,” she said.

After Monday’s rally in Beverly to rescue the North Shore Birth Center, U.S. Sen. Joan Lovely, a Democrat from Beverly, said she and several colleagues plan to meet Friday with health administrators at Beth Israel Lahey to propose the company to postpone the final closure of the center and instead close it temporarily while trying to increase staff.

“Smart people can sit in a room and understand that,” Lovely said. “Because right now it looks like another attack on women’s right to make their own medical decisions.”

You can contact Kay Lazar at [email protected] Follow her on Twitter @GlobeKayLazar.

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