Conn. hospital’s plan to close maternity ward faces opposition

A Connecticut hospital petitioned the state Wednesday for permission to end its inpatient obstetrics program, citing difficulty recruiting medical professionals and a drop in the number of births.

Hartford HealthCare’s proposal for its Windham Hospital was met with opposition from community members and public officials during the public comment portion of the meeting. Speakers expressed concerns over access to health care for a rural community, longer travel times, maternal mortality rates, health disparities and the hospital’s service suspension without a prior public hearing through the Office of Health Strategy.

“As a nonprofit institution, Hartford HealthCare really has to think long and hard about how it is serving the public good,” said state Rep. Anne Hughes, a Democrat whose legislative district includes Easton, Redding and Weston.

“In this instance, it is putting the burden on expectant mothers to do the traveling in what might be the most difficult time of their pregnancy.”

The hospital suspended its inpatient obstetrics program in June 2020 because of “staffing challenges that were insurmountable,” said Jennifer Fusco, an attorney for Hartford HealthCare.

There’s been a growing nationwide shortage of obstetricians for years. In 2017, the American Congress of Obstetricians and Gynecologists predicted there would be a shortage of nearly 9,000 obstetricians and gynecologists by 2020.

Earlier this year, the Association of American Medical Colleges predicted there would be a shortage of 15,800 to 30,200 in surgical specialties, including obstetricians and gynecologists, by 2034. Throughout the pandemic, various hospitals across the country have paused their labor and delivery programs because of staffing shortages.

“The proposal, at its core, is about patient safety,” Fusco said. “It’s about a need to close a labor and delivery service that can no longer be operated in a safe and consistent manner.”

The region has large Black and Hispanic populations, two demographics with higher maternal mortality rates than the nonHispanic white population, speakers pointed out during Wednesday’s hearing.

“This is deemed as a civil rights issue and a violation of those civil rights,” said Leah Ralls, president of the Windham-Willimantic NAACP branch. “… Women have the right to bring life into this world in their own community, safe and sound.”

But several staff members of Windham Hospital spoke in favor of the decision.

Melisha Cumberland, chief of medicine at Windham, said the program’s end was a result of changes in the community.

Cumberland said the low volume means health care professionals are unable to maintain the skill levels needed, in particular, for difficult births.

“With this low level [of births], obstetricians, gynecologists and pediatricians are unable to adequately maintain their skill level to deliver the quality and safety here associated with prenatal obstetrical and medical pediatric care,” Cumberland said.

The hospital has seen fewer births in recent years. In fiscal year 2020, there were fewer than 100 births, according to the hospital’s certificate of need application.

The hospital has the lowest number of births in the state, at 45 from October to March in fiscal year 2020. The highest number was at Yale New Haven with 3,112.

As the number of births at the hospital has dropped, so has the facility’s ability to recruit obstetricians and other specialty staff, said Donna Handley, president of Hartford HealthCare’s East Region, which includes Windham and Backus hospitals.

The hospital plans to provide transportation to and from Backus Hospital or other area facilities for patients in labor, Handley said. She also stressed that the hospital would maintain its prenatal and postnatal care programs.

Backus Hospital is about 17 miles away in Norwich.

“There is no other choice,” Handley said. “We cannot fix this. … If there were physicians to be recruited, we would have recruited them.”

Staff in the obstetrics unit were moved to other departments and none have lost their jobs, according to a Hartford HealthCare webpage.

Many who spoke in opposition to the closure voiced their concerns prior to Wednesday’s hearing through the state Office of Health Strategy.

Among those opposed included state Rep. Susan Johnson, state Sen. Mae Flexer, women who have given birth at the hospital, health care advocates, Willimantic city council member Rodney Alexander, and members of a group called Windham United to Save Our Healthcare. State Rep. Brian Smith and Attorney General William Tong submitted written comments.

“Asking these parents to travel an additional 25-45 minutes in order to undergo a major medical procedure at another hospital is not a mere inconvenience, it creates additional burden and risk for an already vulnerable mother and baby,” Tong stated in his comments.

“To that end, we urge your office to closely examine this application and balance the benefits of ending obstetric services at Windham Hospital with the consequences of doing so and consider what steps might be taken to bolster community-based prenatal and postpartum services for this high need population.”