Obstetrics unit's closing protested

`Loss to community' lamented by mothers at Union Memorial rally

March 15, 2003|By Dennis O'Brien | Dennis O'Brien,SUN STAFF

When she became pregnant, Lisa Moren checked out Baltimore-area hospitals and liked everything she heard about Union Memorial.

The hospital had a high-quality obstetrics unit, a strong nursing staff and a low rate of Caesarean deliveries, all important factors to her.

"It seemed like a real family-oriented place," said Moren, 40, whose baby is due next week.

But yesterday, Moren stood with a group of mothers outside Union Memorial's entrance to protest the hospital's plan to close its obstetrics unit March 25. She said the decision forced her to switch hospitals and seek a nurse-midwife who will deliver her firstborn elsewhere.

Moren remains angry that Union Memorial made its decision to close the obstetics unit a month after she began taking childbirth classes there. The decision was announced in late January.

"They offered the kind of experience I wanted. Now, that's not going to be available to me and a lot of women like me," said Moren, an art professor at the University of Maryland, Baltimore County.

Moren said she has arranged to have her baby delivered at Mercy Medical Center by Kathy Sloan, a nurse-midwife, because her obstetrician does not have staff privileges, or the authority to practice, at Mercy.

Union Memorial officials say they're closing the obstetrics unit because of a steady decline in area births and an increasing need for space for specialty services the hospital has developed during the past decade: open-heart surgery, orthopedics and a hand treatment center.

The hospital plans to use the obstetrics space to expand its heart unit, said Amy Strong Asfa, a hospital spokeswoman. She said four obstetricians are leaving because of the decision but that five obstetrician/gynecologists are staying and plan to expand gynecological services.

Union Memorial tried to attract more mothers in recent years by establishing partnerships with area health clinics, recruiting doctors, upgrading rooms and advertising, said Bradley S. Chambers, senior vice president.

Health care experts say Union Memorial's obstetrics unit fell victim to intense competition.

"In an urban area like Baltimore, there's a lot of alternatives," said Jonathan Weiner, a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health.

Union Memorial reported 869 obstetrics discharges in 2001, by far the fewest of any area hospital, according to the Maryland Health Care Commission. Most area hospitals averaged about 2,500. Greater Baltimore Medical Center had the most, 4,660, and Mercy, about three miles south of Union Memorial, reported 3,048.

Demographic trends also are working against the childbirth business, hospital officials say. Planners expect a statewide decline in births that started in 1990 to continue - and dry up more of the obstetrics market - at least until 2006.

"Birth rates have been going down fairly steadily all over the state," said Pamela Barclay, deputy director of health services for the Maryland Health Care Commission.

Moren was the only pregnant woman among yesterday's protesters. But the group included several women who gave birth at Union Memorial.

They praised the quality of care there and say they're unsure where they will give birth in the future.

"My Union Memorial nurse never left my room," said Cassie Nielsen, whose daughter Madeline is 17 months old. "It's such a loss to the community."

Nielsen and others said they know the closing of the obstetrics unit is unavoidable. They said they held the protest to warn Union Memorial that it will face stiff opposition if it tries to close its emergency room, pediatrics unit or other facilities that serve the hospital's Oakenshawe community and surrounding areas.

They said the community was never informed of the planned closing.

"This is about sending a message that they can't make these kinds of decisions without letting anybody know," Nielsen said.

Asfa said the hospital sent notification letters to regulators, patients and area community associations, and issued a news release in January that resulted in coverage in The Sun and other newspapers.

The hospital also held the state-required public hearing at the hospital Feb. 5.

Union Memorial has no plans to close its emergency room or pediatric unit and will continue to serve the surrounding area, she said.

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