Bellevue Natural-Birth Center In NYC Closes; Catered To Immigrants, Medicaid Patients

Main Category: Pregnancy / Obstetrics
Also Included In: Medicare / Medicaid / SCHIP
Article Date: 11 Nov 2009 - 5:00 PST

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The Bellevue Birth Center in New York City, the city's only in-hospital natural-birthing center primarily dedicated to Medicaid beneficiaries, closed in September without public notice, the New York Times reports. The center served low-income, mostly immigrant women. Around 85% of patients were Chinese- or Spanish-speaking immigrants, a majority of whom were referred through Gouverneur Healthcare Services on the Lower East Side.

Although the center was part of Bellevue Hospital, it was "designed to feel more like a home than a hospital," the Times reports. Patients were allowed to walk around or bathe in a Jacuzzi to reduce labor pain, and they could choose to forgo invasive medical techniques like induced labor and epidural blocks. If complications arose, patients had immediate access to hospital facilities. Supporters of the center said statistics show that births at the facility were less costly and less likely to result in complications than those in Bellevue's regular labor and delivery ward. They also said the center had a caesarean section rate of less than 4% over its lifetime. Citywide, c-section rates in New York hospitals increased from 22.3% in 1998 to 31.8% in 2007, according to the state Health Department.

Bellevue in August announced the center's closure to employees but not to the hospital's community advisory board, which learned of the decision after inquiries from politicians and members of the media. Patients have been redirected to the hospital's 12-bed labor and delivery ward, where they can still choose some natural-birth techniques but do not have access to midwives on all shifts. According to a statement from the hospital, the closure was a response to declining birth rates throughout the hospital -- falling from 2,087 in 2004 to 1,897 in 2008 -- as well as financial pressure. The hospital will face a $30 million shortfall next year, and officials have begun cutting staff and services. The statement said, "In the current fiscal climate and with low demand, it was very difficult to justify maintaining both units."

Richard Jennings, director of midwifery at Bellevue, said that hours at the center were steadily scaled back in recent years, in part because of problems staffing both the hospital's labor and delivery ward and the natural birth center. He said that over the past year, about four out of five women who qualified for admission to the center were turned away, and the number of women who gave birth there fell to 125 from a peak of more than 500. Jennings said he hopes to raise enough private money to hire a dedicated nursing staff to reopen the center (Sulzberger/Pinto, New York Times, 11/7).

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