Nurses working in the maternity unit at Cape Cod Hospital, who are members of the Massachusetts Nurses Association (MNA), along with other concerned hospital staff members, are decrying Cape Cod Healthcare’s (CCHC) recent, but quiet, decision to make drastic cuts to its established and successful midwifery program.
Starting on November 16, midwives will only be available at the hospital 7 p.m. to 7 a.m. Monday through Friday, essentially cutting their in-hospital weekday availability in half. They will be accessible 24 hours a day during the weekends only.
The cuts come at a time when Cape Cod Hospital’s maternity unit is seeing marked increases in the number of babies it is delivering. This increase is, in larger part, due to the influx of pregnant woman who would have previously been cared for at Falmouth Hospital. But with the closure of that hospital’s maternity unit in April, expectant moms in the area are now delivering in Hyannis. Also having a significant impact on those delivery numbers is the overall population increase the Cape has seen due to COVID-19 and people looking to temporarily relocate from more densely populated areas while the pandemic plays out.
The absence of midwives during weekday shifts means that expectant mothers who have chosen to be under the care of a midwife will no longer have access to those same care providers during their labor and delivery — unless a soon-to-be mother is lucky enough to go into labor either at night or on a weekend. Otherwise, new babies will be delivered by obstetricians.
For the maternity nurses at Cape Cod Hospital, who work alongside with both doctors and midwives, this is an unnecessary and unfortunate change in practice. Some expectant mothers do require the care of obstetricians, either due to their high-risk status prior to delivery or because of an urgent matter that arises during labor. But many expectant mothers have low-risk pregnancies and opt for midwifery care. This allows mothers to have more say in their birthing plans, resulting in labors and deliveries that are less clinical, more wholistic, and generally non-invasive.
The announcement of these cuts has shocked many nurses and clinicians at the hospital. Not only have deliveries been on the rise, but the hospital has continued running promotions that tout its women’s health and midwife programs. Meanwhile, nurses report that there has been no clear communication with the public about the hospital’s looming changes.
“When CCHC closed the maternity unit at Falmouth, we knew we would see a significant increase in deliveries in Hyannis,” said Michelle Walsh, RN. “At the very least we have been expecting to deliver 300 more babies this year. Little did we know that CCHC would make things worse by cutting patients’ access to midwives at a time when the Cape’s lone maternity unit is already understaffed and overwhelmed.”
The closure of the maternity unit at Falmouth was strongly opposed by local nurses, clinicians, patients, and advocates, and following a public hearing on the matter the Department of Public Health (DPH) deemed the unit and the services it provides as essential. But the DPH does not have the authority to prevent such closures and CCHC charged ahead with shuttering the Falmouth unit.
The Falmouth closure, and now these pending cuts to the midwifery practice at Cape Cod Hospital, follow the recent elimination of maternity services at Morton Hospital in Taunton and Tobey Hospital in Wareham. As a result, the March of Dimes has classified this region of the state as a “maternity desert” for the lack of access to adequate obstetrical care.