Mt. Sinai West Hospital.
By Joy Bergmann
During an internal meeting last week, leaders of the OB/GYN team at Mount Sinai West hospital announced the January closure of its pioneering Birthing Center, opened in 1996 as the first hospital-based birthing center in New York City. The hospital is on 10th Avenue between 58th and 59th Street and was formerly called Roosevelt Hospital.
Parents, grandparents, midwives and other advocates for the home-like, childbirth facility – intended for women with low-risk pregnancies who seek a more relaxed environment to give birth without epidural anesthesia – have vowed to pressure Mount Sinai executives to reconsider this decision.
A group calling itself Save The Birthing Center has started an online petition seeking 2,500 signatures, saying, “If it closes there will only be one in-hospital birthing center in all of New York City. NYC families deserve autonomy and choice when deciding where to give birth. Help save the MSW Birthing Center!”
Asked about the impending closure, Mount Sinai emailed the following statement to WSR:
“In order to make the critically necessary expansions of our Neonatal Intensive Care Unit (NICU) along with enhancing the services of our Labor and Delivery Unit, we have had to reevaluate the use of space within our obstetrics footprint. The newly configured Labor and Delivery area and NICU expansion will allow us to provide improved patient safety, comfort and delivery of care to all mothers and infants, especially those who require extra care.
Mount Sinai is committed to providing patient-centered care for all expectant mothers and supporting each mother’s unique childbirth experience. We respect a woman’s birthing choice and will continue to offer the option of a childbirth experience that includes low medical intervention, accessibility to midwives, and one that ensures the health and well-being of both mother and baby.
While the Birthing Center at Mount Sinai West will no longer exist in its current capacity after December 2018, we believe the concept of a natural, low-intervention delivery is not bound within four walls and choice of a natural childbirth experience will continue to be available to all expectant mothers who deliver at Mount Sinai West. We remain committed to our mission of providing compassionate, personalized care for all expectant mothers.”
Risa Klein, Certified Nurse Midwife, says she was present at the grand rounds meeting last Tuesday when officials made the announcement. “There had been rumors of changes coming, but you never expect it.”
Klein says the hospital is very supportive of midwives and new mothers – even the traditional Labor & Delivery rooms have tubs – but that the Birthing Center is something special and worth protecting. “The real downside loss would be the loss of that in-house community people look to,” she said. “The Birthing Center is like being at home, but with the safety net of first-class medical facilities being just one floor away in the unlikely event of something challenging happening to the baby or mother. It’s a real comfort and would be a loss for the community.”
The importance of choice is a consistent refrain among those who’ve already signed the petition.
“NYC desperately needs low-risk birthing options within a hospital setting,” wrote Vanessa Cariddi.
“Without birthing centers, women have only two choices: medicalized hospital births or home births.”
“All mothers deserve the right to choose a birthing center,” added Alex Passas.
And Karie Brown wrote, “I gave birth there – a glorious experience – and it breaks my heart to know that Mt. Sinai wants to take that experience away from others.”
“We respect a woman’s birthing choice” Mt Sinai
Didn’t George Orwell write a book with similar phrases?
No.
I already knew that you haven’t read Orwell. You are just that obvious.
Are you suggesting he did?
Irony or Doublespeak?
Dollars to donuts this is a simple matter of Mount Sinai running some numbers that show it can get greater reimbursement for beds that aren’t part of a low-intervention Birthing Center.
Shame on New York State government for allowing hospitals to grow so large, soulless and completely profit-driven.
A number of years ago Mt. Sinai closed down its Women’s Health Center in the Faculty Practices building on East 98th St. The rumored reason was that it wasn’t making enough money. It was a fantastic facility: you could go there for regular care by your primary physician as well as reproductive healthcare, gynecology, mammography, and, IIRC, bone density screening, all in one place. It was a comfortable, safe place with top-notch doctors, PAs, and nurses. When it closed, my primary physician went into private practice and I am still fortunate to be in her care.
I remember and miss the old Roosevelt Hospital, which took up the entire 9th avenue side. Their Emergency Room was efficient in how they handled walk-ins.
Supply and demand. If people were using it, they would keep it. They believe the space can be used more efficiently for something else, so that is what they are doing.
Health care costs in this country are already astronomical. Inefficiently using space at a crowded urban hospital will only drive costs up further.
Just the opposite. It is using space for higher-paying services, as Mt. Sinai is doing, that is driving healthcare costs up.
Its not about the space, its that medical intervention is how the hospital makes money. If women don’t use the constant fetal monitors, don’t get epidurals and have fewer c-sections then the hospital makes less money. I gave birth in both the Birthing center and the standard L&D at Sinai and the experience is SO different. The BC experience was serene and humane. The L&D was a machine for pushing unnecessary interventions. I ended up with a natural birth thanks to my midwife but the doctors tried to push epidurals, piton and even forceps because I pushed for more than an hour. (I pushed for three). Baby was born fine without all that stuff. But the hospital still got to charge me for the Heplock I didn’t need and the fetal monitoring I didn’t ask for. THIS is why medical costs are out of control in this country.
Applying “Supply and Demand” to hospitals is inhuman. But hey!
There is something called scarcity of resources. Hospitals must deal with this. They have a limited amount of space and dollars. Health care is already ridiculously expensive in this country, so they can’t just keep throwing money at problems.
That being said, hospitals do have a certain obligation to the public, such as through charity care, and most do an admirable job of this.
They must make tough decisions regarding how to best use their resources. It is very easy to sit in front of our computers and second guess their decisions because the programs that are important to you personally are being cut. But unless you care to personally fund those programs, let’s let the professionals do their jobs. I have worked professionally with the management of many not-for-profit hospitals and they take these decisions very seriously and make them very responsibly.
Unfortunately, it seems like second guessing other people seems to be the cottage industry of the UWS…
“It is very easy to sit in front of our computers and second guess their decisions because the programs that are important to you personally are being cut.”
Stop attempting to degrade “our” experience with childbirth and the experiences that are shared. I mentioned mine in a separate comment, as did Rachel, Filatura, Kate, and Uwsmom (a personal fav). By the way, you should know that “the programs that are important to you personally are [NOT] being cut. I care about this for others, probably a foreign concept.
“But unless you care to personally fund those programs, let’s let the professionals do their jobs.”” Here it is again!!!!!!!!!!! Unless I pay for the newstand, unless I pay for the homeless man to have shelter, unless I pay for the friggin’ hospital, I should just shut up! Really?
But the real giveaway is this: “But unless you care to personally fund those programs, let’s let the professionals do their jobs. I have worked professionally with the management of many not-for-profit hospitals.” You want to be able to make these decisions without hearing the effect they have on PEOPLE. You want to censure any reaction by PEOPLE. But you are the “serious” ones to make this decision.
Apparently it doesn’t get used much. I gave birth there earlier in the year, but I think in retrospect a natural birth in a regular L&D ward would have been better – so many heavy handed hospital policies in the birthing suite and you are a floor away from theater if something goes wrong
So you are all good with “so many heavy handed hospital policies in the birthing suite” so just go ahead and close the Birthing Center?
Ever give any thought to trying to get that handedness changed instead.
Talk about throwing out the baby with the bathwater.
It isn’t like they are shutting it down to build slot machines. Doesn’t it say they’re building a neonatal ward? That seems worthy too. Not everything is an outrage. It sounds like this is a loss for some, but got others, it will be a life saver. There is something to be said for filling demand (meaning providing the medical resources that are needed, which doesn’t seem inhuman).
No loss to the mothers electing for a natural childbirth without an epidoral.
They now are told to stay home.
I see that as a loss to AT LEAST the mother, the baby, and the father.
But USA currently has the highest death rate from pregnancy in the developed world. So why not raise so what’s a few hundred more?
You must know that this is due to insurance reimbursements to the hospital. But you must believe the insurers should call the shots and not the parents.
dannyboy wants what he wants, when he wants it. Who cares about what it costs and who is going to actually pay for it? In the real world, choices have to be made and as a result, sacrifices have to be made. I am personally willing to pay taxes and donate money to causes that are important to me, but at some point there is a limit.
As others have noted, there are smart, caring people who are making these difficult choices and they are never going to make everyone happy. And as proven by this web site, there are some people who just can never be happy unless they are complaining.
Juan, you have now made at least 10 attempts to quell any dissent from your point of view.
You have used insult and outrage, but never facts.
Not once.
I’m a mom, and I want the birthing center. So do the 4,200 other people who signed the petition. Sacrifices have to be made? We are talking about birth here.
I don’t think we should have to chose between an expanded/upgraded NICU or the birthing center. Both are needed. And the language from Sinai suggested that this isnt just about the NICU (see Rachel’s commemt).
This is an amazing story, thanks WSR for breaking it.
I can appreciate why people are upset, but a few things should be noted:
1) Obstetrics Departments in hospitals are money LOSERS. Hand over fist, OB loses more money due to insurance costs and law suits than virtually any other department. But, babies need to be born and sometimes it can be medically intensive.
2) You can still hire a midwife and do it elsewhere. Many women do.
3) Mount Sinai delivers over 17,000 babies annually in NYC across all socio-economic levels.
4) Many women at MSH receive completely free prenatal -> Birth -> postpartum care. FREE!!!!
It is really not fair to bash Sinai administration for this decision. They acquired a medical network, nay they rescued medical facilities that were bankrupt and going to close.
Remember St. Vincent’s?
We should be thanking Sinai for doing what they can to ensure access to the highest level of quality care to the entirety of NYC – Rich or Poor
You lost me at “Obstetrics Departments in hospitals are money LOSERS.”
Is medical care only delivered to the profitable?
What about those people who are UNprofitable?
Sinai is a non-profit hospital. The administration does not seek profit. They do however need to run an organization capable of generating enough revenue to survive, advance and if necessary grow with the increasing needs of the community.
The reason Sinai has taken over Roosevelt, St. Luke, New York Eye and Ear Infirmary, and Beth Israel Medical Center is because they were bankrupt. Losing these hospitals would have devastated the city.
Mount Sinai Medical Center borders one of the wealthiest and one of the poorest communities in the continental U.S. Yet, the same doctors treat and assess both the wealthy and the poor.
Please don’t suggest these caring people, many of whom have spent decades of their lives caring for NYC families out to be greedy, self-serving profit seekers.
I would never:
“Please don’t suggest these caring people, many of whom have spent decades of their lives caring for NYC families out to be greedy, self-serving profit seekers.”
Just the opposite. I support the Mt Sinai medical professionals in the constant battle with the administration (you know, like the “serious people” who axed the Birthing Center).
I care too much about Mt Sinai and depend too much on their medical services. They are the only medical practioners that I use.
Thank you for this thoughtful, fact-based comment.
You want FACTS:
“The US has a shameful record when it comes to caring for its moms. As Ars has reported before, the rate of women dying during pregnancy or childbirth is higher—much higher—than in any other developed country. By some estimates, mothers die in the US at a rate six-times that seen in Italy and three-times the rate in the UK, for instance. And of those that survive, tens of thousands suffer devastating injuries and near-death experiences each year.
It’s hard to compare such stats with precision, of course, because official numbers don’t exist in this country. US hospitals either won’t reveal or don’t determine rates of maternal complications, and the country as a whole simply doesn’t monitor the deaths consistently or accurately. The US hasn’t reported an official maternal death rate since 2007—a situation health experts have called an ‘international embarrassment.'”
https://arstechnica.com/science/2018/07/why-do-so-many-moms-die-and-suffer-in-the-us-stupid-negligence/
Update: NYC IS changing their data collection (aka “an ‘international embarrassment.’”)
Under the new plan, the city will improve the data collection on maternal deaths and complications.
Why, you may ask?
“In New York City, the racial disparity in maternal outcomes is among the largest in the nation, and it’s growing. According to a recent report from New York City’s Department of Health and Mental Hygiene, even as the overall maternal mortality rate across the city has decreased, the gap between black and white mothers has widened.”
Again, heading to be #1 in the #1 country leading deaths in the developed world.
From my experiences with the Birthing Center, there was high demand. I couldn’t get in when I delievered my first child because it was full. I was able to get in with my second but it also filled. Delivering in the L&D unit was fine, but the birthing center is a totally different environment and process. Mothers should be able to chose when it comes to how they want to give birth.
There is only one other Birthing Center in NY. Most insurance will not cover a home birth.
Hospitals and healthcare providers should be making decisions based on people and not profits.
What is the other birthing Center in nyc?
Before the place closed and become luxury condo housing, Saint Vincent’s in Greenwich Village had a very well known and respected family birthing center.
https://www.nytimes.com/2010/04/10/nyregion/10bigcity.html
https://www.nydailynews.com/new-york/eli-abby-manning-donate-funds-new-birthing-center-st-vincent-hospital-article-1.412680
Prior to that there was the StV affiliated Elizabeth Seton Childbearing Center, which operated for thirty years before being forced to close over insurance expenses.
https://brooklynrail.org/2003/11/local/eliminating-the-middlewoman-elizabeth-seton-closes-its-doors
Keep in mind that Mount Sinai is closing and tearing down Beth Israel hospital on the east side. Maternity services have long ceased at BI and moved to Mount Sinai’s other hospitals including Mount Sinai “West”.
https://town-village.com/2017/02/23/beth-israel-plans-to-stop-delivering-babies-in-may/
This could (and likely is) factoring into Mount Sinai’s plans for dropping the birthing center/reconfiguring things as noted above in OP.
Believe it or not there are only four private major full service hospital/healthcare systems in Manhattan.
NYP/Cornell, Northwell, NYU, and Mount Sinai pretty much have a lock on things, and all are in competition for same patient base; those with good to excellent insurance.
NY Pres – Lower Manhattan. I believe there is another in Brooklyn.
Moms are so smart!
(Again!)
There is another factor as well. As many women are choosing to give birth a few years later than what was typical a generation ago, they are no longer considered “low risk”. While most have no difficulty they are a significant number of women in their late 30’s who dialate early, have gestational diabetes, present with placenta previa and high blood pressure. For them (now nearly the majority of women) laboring for hours without medical intervention is no longer feasible. If that it the case, then it would make better dollars & sense for the hospital to offer low-risk births combined with their higher-risk mothers on floors where they can be properly checked by physicians & nurses in a more integrated manner. Better use of their funds.
The Birthing Center had certain requirements to meet if you wanted to deliver there. If you had a high risk pregnancy with the type of complications you described, it would not be an option for you.
My children were born at Mt Sinai. When my wife had a high-risk pregnancy, she received WHATEVER was deemed best for her and within her wishes. She wanted me to stay overnight and the hospital agreed. This article is so disheartening for parents today.
“then it would make better dollars & sense for the hospital to offer low-risk births combined with their higher-risk mothers”
You other mothers deserve to receive what YOU need, not what some MBA decides for you.
I am so glad that my children were birthed in a saner world.
I wish that I believed that the administration cared more about mothers and quality care than about the almighty dollar, but this is just another example what is deemed most important and patient care is not one of the highest items on this administration’s agenda
Yet another amenity for New Yorkers goes the way of fiscal irresponsibility. How else to explain this closure?
St. Luke’s/Roosevelt Hospital’s birthing center was world renowned for its excellent work.
We’re #1
We’re #1 Again
U.S. “most dangerous” place to give birth in developed world
https://www.usatoday.com/in-depth/news/investigations/deadly-deliveries/2018/07/26/maternal-mortality-rates-preeclampsia-postpartum-hemorrhage-safety/546889002/
A great blow to natural childbirth & to mothers who wish a home-like birth. The hospital’s assertion that they remain committed to alternatives is nothing short of specious.
No. NO! NO!!!
The birthing center was established before 1977 as I went there for all my prenatal care. It was staffed only by midwives. My son was. orn there in May of 1978.
Sounds like they are looking to make more money, plain & simple. All these hospitals are merging & price gauge everyone. Although NICU is a necessity is really more space for Labor & Delivery that brings in more dollars than a birthing center. Nice try Mt Sinai, won’t be using you anymore for my delivery.
I gave birth to three kids at Mount Sinai West, two with epidural and one completely natural. I was considered too high risk to use the birthing center due to my age, though I would have preferred that environment. But I was clear what kind of experience I wanted (mostly to be left alone) and the nurses and doctors there were very supportive.
I was told that the birthing center was not open every day due to staffing problems so that some women who planned to use it could not. Also the rules about who qualified really were quite limiting. I understand from a liability perspective but truly, a healthy 35 year old without pregnancy complications ought to be able to understand the risks and choose birth without monitoring. That’s kinda an average mom in NYC. I’m not surprised that it closed.
“I was told that the birthing center was not open every day due to staffing problems so that some women who planned to use it could not. Also the rules about who qualified really were quite limiting.”
So it closed incrementally.
Deceivers too.
Just so everyone knows, under NYS laws a parent or person can bring a malpractice suit for injuries caused at birth until the “child” is 21 years old.
Hence reason malpractice insurance for L&D and or anyone or thing connected is rather high in this state.
Those high rates as noted above killed off Elizabeth Seton BC (which would have folded in a few years when St. Vincent’s went bankrupt, but still), and otherwise have a heavy influence.
Yes,elderly primigravida is far more common today than in past. But that does not mitigate risk factors, and or fact that at least in NYS a mom to be can sign all the informed consents in world. But if something goes wrong a malpractice lawsuit is likely to follow.
I gave birth in the birthing center because, among other reasons, I wanted to labor in whichever position I chose, without a fetal heart rate monitor restricting my movement. I wanted to avoid a potential spiral of interventions, such as pitocin, epidural, episiotomy, cesarean and more. My hopes were realized: I was able to have a drug free healthy birth, I did not deliver my baby in the lithotomy position. In fact, during late labor, I tried that position and it was not effective for me. I was happy to give birth with my loved ones, my excellent doctor, and the skilled birthing center nurse by my side, knowing that if complications occurred, I would be treated much more quickly than if I birthed at home. It was so sweet having my husband sleep next to the baby and I that first night of life. That is a wonderful memory.
Mt. Sinai is nothing but a for-profit business. It has no heart whatsoever. Totally about the bottom line for its shareholders.