by Candace Curlee, CNM, MS, ACNM Region VI Representative
A curious thing happened last month in Ventura County, CA. St. John’s Pleasant Valley Hospital in Camarillo decided that midwives can no longer practice at their facility. Midwives have been practicing at St. John’s for the past 30 years. Evidently, the pediatrics and obstetrics committees along with the board of directors made the decision for “safety reasons.” Midwives were not included in the discussion.
One would assume this was related to bad outcomes; however, no peer review on the midwives’ quality of care occurred prior to the decision. In fact, the letter notifying staff midwives, three days prior to their effective dismissal, said that the loss of hospital privileges was not a reflection upon the care provided. The letter also stated that there was no allowance for a hearing or review.
The odd part of this whole situation is the board and committees’ reasoning. They say that because the hospital does not have a neonatal intensive care unit (NICU), it is unsafe for midwives to attend birth on the premises. However, physicians continue to deliver babies at St. John’s Pleasant Valley, including cesarean births, which statistically have more risk for a newborn to be admitted to NICU. Officials at the hospital have been mute, except to insist that this new policy is all about patient safety without further explanation. They declined to respond when asked to release statistics of babies admitted to NICU whose birth was attended by midwives as opposed to those attended by physicians.
In general, midwives care for women who are at low risk for complications. Numerous studies, including a recent Cochrane Review, testify to the high quality and safety of midwifery care. In fact, research indicates that midwifery care may reduce the risk of neonatal morbidity and mortality and therefore the need for NICU admission. Birth Action Coalition, is spearheading a campaign to force the hospital to rescind this unjust and unsubstantiated policy. If you live in the area, please join them at their next rally Friday, March 19, 11am to 1pm.