Medical professionals at West Suburban Medical Center continue to decry worsening patient safety at the hospital after midwives and family medicine doctors were told Nov. 18 that they would no longer have birthing privileges at the hospital.
They said they were told that the move is because of liability insurance issues, although they have been performing labor and delivery services there for more than 20 years.
And in a new turn, the week after the midwives and family medicine doctors’ last day on Dec. 6, West Suburban CEO Manoj Prasad said that they may return, although with changes to the contract. He said this had been an option all along.
The midwives and family medicine doctors dispute that account.
They operate out of the PCC Community Wellness Center, which contracts with West Suburban to provide services. During the past two decades, PCC providers have delivered most of the babies at West Suburban. Last year, midwives and family medicine providers delivered about 700 babies at West Suburban and the PCC’s Birth Center, according to a statement from PCC Community Wellness Center.
Medical professionals say that removing midwifery services is an issue of birth equity.
“To us, it’s access, it’s birth equity, it’s leaving a disenfranchised community in the lurch,” Annette Payot, director of midwifery for the PCC Community Wellness Center, previously told Growing Community Media, the parent company of Austin Weekly News and Wednesday Journal.
In Chicago, the maternal mortality rate is nearly six times higher for Black women than white women. Of about 500 patients that midwives and family medicine doctors cared for, about 43% are Hispanic/Latino, and 44% are Black, according to Dr. Kate Rowland of the Illinois Academy of Family Physicians.
Midwives help reduce rates of cesarean sections, premature births and newborn morbidity, according to the American College of Nurse-Midwives, offering potentially lifesaving care for those whom the health care system often leaves behind, like people of color.
PCC providers said that Prasad originally told them that they would not be allowed birthing privileges to help these patients because the hospital’s liability insurers warned that if Prasad did not make a change, securing insurance in the future would be difficult.
Prasad said there was more to his message.
Last week, Prasad said he sent a letter to PCC midwives and family medicine providers saying they can deliver at the hospital under the supervision of an OB/GYN, but not with a PCC physician.
He added that he verbally explained this offer to Paul Luning, PCC’s chief medical officer and a family physician, on Nov. 18. Prasad added that Luning immediately declined the offer.
Luning did not respond to an interview request by the time of publication.
But Luning earlier said that West Suburban violated the Illinois Licensing Act when it only gave 11 days’ notice, rather than the required 15 days. And the group of the dismissed midwives and doctors filed a complaint with the Illinois Department of Public Health because of the short notice ahead of a major change in their jobs.
But midwives and family medicine doctors said that delivering under the supervision of an OB/GYN was never part of the original offer.
Last week, West Suburban posted a photo on Instagram with a caption that appeared to provide a comment about the situation.
“Our offer to have PCC midwives work with our highly trained OB/GYNs to continue to provide care stands and we are hopeful they will accept.”
Dozens commented on the post, many saying that they were never told this was an option.
“That’s so strange. Maybe you lost all of our addresses,” one Instagram user wrote. “No one in our group received this offer in writing.”
“Offers should come in the form of writing – specifically after the only written documents provided to the midwives stated they had no delivery privileges,” another Instagram user said.
Liability insurance
In a Nov. 20 email, Prasad told GCM that he told PCC midwives they could no longer deliver babies because of information he received from the hospital’s professional liability insurers.
“I recommend eliminating baby deliveries by family practice physicians altogether and only allowing midwives to deliver if under the supervision of a qualified obstetrician gynecologist,” according to a document a West Suburban spokesperson sent to GCM. The name of the insurer was redacted.
“Without implementation of my recommendation, I believe securing future professional liability insurance coverage. … will be severely limited, if possible at all.”
If West Suburban didn’t follow this advice, it would leave the hospital to self-insure liability claims in the future, according to the document.
In a statement, Carolyn Fitzpatrick, the hospital’s chief medical officer, said “in the past decade alone, West Suburban has paid out more than $126 million in claims against the OB/GYN department under PCC’s leadership.”
“This is not just a financial problem for the hospital,” Fitzpatrick added. “It means patients are not receiving the outcomes from West Suburban that we all believe they should.”
PCC providers could not be reached for comment by publication.
Medical professionals who have worked on the labor and delivery unit also pushed back, saying that the lack of midwives and family medicine doctors could be dangerous.
Births that two weeks ago were assisted by two attending physicians, a midwife and resident doctors are now administered by just an OB/GYN and resident doctors.
“Certainly, we didn’t feel overstaffed with our last model,” Payot previously told GCM. It is not yet clear whether the workload can be handled without PCC staff.
There are still three PCC OB/GYNs delivering babies in labor and delivery, along with providers from OBHG, a national hospitalist group that Prasad hired in July. He said OBHG shares concerns about offering equitable labor and delivery services.
“This team is made up of predominantly African American women OBs who are especially committed to advancing the birth equity goals we all share,” Prasad said in his letter to PCC providers.
Patient safety concerns
This isn’t the first time that West Suburban employees have said that patient safety is at risk, since resident doctors organized a demonstration in May, picketed outside the hospital in June, and later wrote an open letter citing additional concerns. Following the changes in the labor and delivery unit, more medical professionals are coming forward with new complaints about how the hospital is run.
They say:
- The neonatal unit has not had baby bracelets for over two months. The baby bracelets have alarms that go off if the baby leaves the unit or the tag is removed by someone – not necessarily a random person, but more likely an abusive partner or support person that those in labor bring with them to the hospital. In lieu of the bracelets, there’s a security officer on the floor at all times.
- One floor of the hospital’s overhead intercom system is broken, so staff can’t hear when there’s an emergency.
- For two weeks, the OB floor’s operating room was too hot.
- The hospital’s lobby is closed on the weekends, so visitors enter by the ER, where they have access to the entire hospital, which staff says is a security and infection- control concern.
- Because an elevator is broken and has yet to be fixed, staff cites a case of calling the fire department to carry patients up the stairs to dialysis.
Although some staff members said they used to have an internal system to report patient safety concerns, they also said the hospital’s risk management employee was let go and replaced with a part-time employee. Prasad did not respond to a request for comment by publication.
Community demands answers
The community surrounding West Suburban – concerned about recent complaints, the future of the hospital and how this move affects birth equity on the West Side – are pushing for answers.
“We have to do everything we can to work together to ensure West Sub is operating in excellence and that our community has accessible options for mothers, such as midwifery delivery services, infant care, and prenatal and postpartum care,” said Emma Mitts, alderwoman of the 37th Ward, in a statement. “This is bigger than all of us. These two institutions are saving lives, and we need them. So, we must do everything we can to help them maintain their commitment to our communities.”
Nearly 2,000 people have signed a Change.org petition created by Oak Parker Melissa Chrusfield, which calls for the formation of a community oversight board to improve accountability and birth equity at West Suburban.
“We express our collective disapproval of the leadership of West Suburban Medical Center, whose poorly planned decision to remove delivery privileges [from] Family Medicine Physicians and Midwives has put pregnant people and their families at risk and has also obstructed our quest for birth equity and improved maternal health outcomes on the West Side.”