The closing of York Hospital’s birthing unit appears to be just one more small hospital’s maternity unit biting the dust in the whirlwind of changing times and finances. Luckily, families living near York are blessed with other good choices for having their babies at locations not too far away. Yet, as one of the original birthing nurses, I am very sad to see the birthing unit close.
In a time when expectant mothers were caught between the desire for a home birth versus the increasingly overmedicalization of hospital births, York’s birthing unit offered a safe alternative. Mothers could labor in a home-like setting but have experienced caregivers and an operating room nearby should something go wrong.
Based on the way mothers in the Netherlands and Denmark receive pre- and post-natal care, we developed a unique model in which birthing nurses cared for pregnant women in doctors’ offices, in labor and delivery, for newborns – mostly in their mothers’ rooms, and with follow-up phone calls and home visits. Our hope was when a woman arrived in the birthing unit, she would be met by a nurse she already knew.
To do so meant all birthing nurses had to be cross-trained in all aspects of maternity nursing, something no other hospital I know of has ever required of its staff. When I joined the birthing unit, I had an excellent background in teaching postpartum nursing and was an expert in helping mothers breastfeed. But my labor and delivery experience was limited. I spent months under the watchful eye of Elizabeth “Beth” Wilson, who later became the maternal-child nurse educator for the state of Maine, until Beth deemed me ready to “fly solo.” In return, I shared what I knew with my fellow nurses – and lots of mothers – about breastfeeding.
Two necessary parts of our system made it work. The first was the unusual schedule we birthing nurses were willing to work. The second was the sense of collaboration all of us, including our obstetricians, family practice doctors and nurse midwives, bought into. We met weekly to discuss plans of care for women about to give birth as well as any problems we encountered with other families during the previous week. For example, we knew that young Navy wives often had trouble finding child care and would ask to go home as early as possible. We did our best to make that possible in the safest way.
Our view of collaboration came from York Hospital’s own sense of what York Hospital is and how it fits into the community, a result of York’s participation in a project about collaboration among health care professionals several years earlier. From the medical staff to the people who served patients’ food, it was deemed so successful the hospital adopted and built on that sense of collaboration. It went on to influence other hospitals in southern Maine and coastal New Hampshire.
The death knell of York’s birthing unit saddens me a great deal, even though I am in my 70s and retired. What ended it was not our willingness to be there for patients whatever the circumstances. That was never lacking.
My belief is that what rang the bell was technology. Mothers today have had ultrasounds long before their babies are born. They can choose to know their babies’ sex, and, with the correct ultrasound equipment, see what their baby looks like before birth. Few women want the pain they associate with “natural childbirth.” They anticipate having an epidural.
Times have changed. I get that.
That said, in nearly 40 years of teaching nursing, and taking students to six different hospitals in Maine, New Hampshire and Massachusetts, I was part of many models of maternity care. None of them compared to York. To quote my good friend and fellow birthing nurse, Linda Anderson, “We were Camelot.”
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