Letter to Quorum From Oregon ACNM

This is a letter written by Emily Yeast the (President, Oregon Affiliate of the American College of Nurse-Midwives) to Quorum Health (the owner of McKenzie-Willamette Medical Center)

April 11, 2023

To Quorum Health and the leadership of McKenzie-Willamette Medical Center:

I am writing on behalf of the Oregon Affiliate of the American College of Nurse-Midwives to express our concern and dismay over your closure of the midwifery practice at McKenzie-Willamette Medical Center. This practice provides exceptional and essential care to pregnant and birthing people in Eugene; its loss will limit healthcare access for these families. In the midst of a well-publicized maternal health care crisis, you are moving against the tide of best practice.

Certified Nurse-Midwives (CNMs) deliver 20% of the babies born in Oregon, and of those over 85% are delivered by CNMs in hospitals. While some families do opt for birth at home or in a birth center, many need to be in a hospital due to risk factors, insurance coverage, or simply by preference. The care midwives provide in hospitals is invaluable; time and again it has been shown that CNMs provide high quality, low-cost, evidence-based care. Your practice was the only hospital-based practice in Eugene offering 24/7 midwifery care for pregnant and birthing people.

From both a public health and business perspective employing midwives just makes sense: a series on midwifery published in The Lancet demonstrated that midwifery care results in excellent outcomes and lower costs due to fewer unnecessary and expensive interventions, and that recipients of midwifery care consistently report high levels of satisfaction. The World Health Organization recommends midwives take the lead in providing care through pregnancy and childbirth, citing that this model has been proven to reduce preterm birth rates by 24%. Furthermore, the American College of Obstetrics & Gynecology recognizes the crucial and complementary role that midwives play and the value of fostering interdisciplinary maternity care teams.

Your new midwifery practice grew – in the midst of a pandemic! – to provide 200 births in 2022. The midwives worked long hours with few resources and little support, and yet provided care far better than the national average. in 2021 their NTSV cesarean section rate (a widely used metric for evaluating quality of care) was 16%; the nation average is 26.3%. And yet, you made the decision to close this practice without any input from the very people that built it and that best know the needs of your patient population. At a time when there are national and statewide efforts to increase access to midwifery care, you have chosen to close the only hospital-based CNM practice in Eugene.

I invite you to reconsider. In partnership with your midwives you can build a strong midwifery practice that provides essential care to your community.

Emily Zeno Yeast, CNM President, Oregon Affiliate of the American College of Nurse-Midwives