Effective March 1, Ascension Providence Hospital's Alternative Birthing Center will be phasing out its use of midwives. Instead, the center will be staffed by obstetric physicians.
It's a decision that's forcing many expectant moms to change their birth plans. People often use midwives for low-risk births to avoid surgical interventions.
“They allow you to walk and move and use whatever avenue you’d like to pursue to help your labor progress," said Marissa Guysky, who is due with her second baby in April.
She delivered her first child at Ascension Providence's ABC, driving all the way from Fenton.
“Because it was such a good experience, I was hoping to do it again," she said, favoring the patience and more holistic approach that midwives often bring to the delivery process.
But now, in wake of the decision to stop staffing the ABC with midwives, Marissa is changing her birth plan just weeks before delivery.
In a letter dated Feb. 15, Ascension states that Providence Hospital "will be transitioning away from providing midwifery services effective March 1, 2023. At that time, all deliveries will be performed by our highly qualified obstetric physicians who also specialize in low-intervention births."
That letter goes on to say that moms and babies will continue to have access to the highest level of infant and obstetrical care and that the policy change won't impact patients' relationship with Ascension Providence Hospital, or their access to the Alternative Birthing Center.
However moms like Marissa and Leah Hettinga, who is due any day now, want answers from the health system. Hettinga reached out to Ascension after hearing the news earlier this month.
“I got kind of a trite answer back saying we’ll still be taking care of mothers and babies and they’ll be safe here and does that answer your question? And it didn’t," she said.
Ascension released the following statement to Action News on Feb. 12, the same day a rally was held outside the hospital, seeking to stop the change:
"Families that wish to utilize a private practice certified nurse midwife are welcome to include them in their birthing experience, provided they have the necessary privileges to provide such services at Ascension Providence Hospital. Private practice certified nurse midwives with appropriate privileges are welcome at any Ascension Michigan hospital that provides labor and delivery services.
Ascension Providence Hospital continues to offer obstetric services to ensure a high-quality, safe experience for expectant parents throughout their pregnancy and the birth of their child. Moms and babies will continue to have access to the highest level of infant and obstetrical care including maternal-fetal medicine and neonatal specialty care, a level III neonatal intensive care unit, 24/7 obstetric emergency care, and more. Deliveries are performed by our highly qualified obstetric physicians, who also specialize in low-intervention births."
That rally, which both Leah and Marissa attended, was sparked by this petition, started by local Doula Celeste Kraft, who states on the petition's page "In a state where the preterm birth rate among Black women is 55% higher than the overall population, and in a country with a dismal maternal mortality rate that is four times higher for Black women than white, it's unconscionable that out-of-state number crunchers would fire the very care providers who are best positioned--by training, by location, and by a proven track record--to positively impact these numbers."
Leah felt compelled to attend the rally for herself, and in support of the midwives at the ABC.
"For the model of care to be discontinued, it is a disservice to the community," she said.
Lee Roosevelt is the president of the Michigan Chapter of American College of Nurse Midwives, and also teaches at the University of Michigan. She said data shows the best patient outcomes tend to be at hospitals with integrated systems, meaning both physicians and midwives available to assist with labor and delivery.
“As much as it would be inappropriate to expect a midwife to provide care for high-risk, sick people - I think it’s also inappropriate to expect physicians to have the necessary skills and training to how we support people during labor," she said.
Speaking about a midwife's role in general, “We view our role as sort of continued support, advocacy throughout the whole labor process. We’re really bedside with that patient," she said. "And I think that’s difficult to replace.”
While Ascension states patients are welcome to include private practice nurse midwives with necessary privileges, getting those privileges takes time, Roosevelt told Action News.
“What we know at the American College of Nurse Midwives is that once the Ascension midwifery practice is closed, we have no nurse midwives in the State of Michigan who are credentialed at Providence Southfield," she said.
This isn't the first time Ascension has made cuts to midwives on staff. This spring, it cut the midwifery staff at Ascension Borgess in Kalamazoo in half.
Amanda Ezekiel worked as a certified nurse midwife at Ascension Borgess from 2016 until 2022. She said this latest cut at Ascension Providence feels like a collective gut punch to the midwifery community.
"I mean I wasn't entirely surprised, because it happened to us. But it still hurts," she said.
Ezekiel now works at another health system on the state's west side.
We have reached out to Ascension by phone and email, asking for clarification about what went into this decision at Providence. We are still waiting to hear back, and will update this story if and when we do.
Marissa is now planning to deliver at another hospital, where a midwife will be available to her.
