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Hospital To End Maternity Services

The recent decision by North Shore-LIJ Plainview Hospital to file plans with the state to discontinue maternity services in November has drawn both support and opposition.

According to North Shore-LIJ spokesman Terry Lynam, the hospital has seen a 30 percent drop in deliveries over the past three years and Census data showing the region-wide decline in births will continue.

“The volume of maternity cases at Plainview declined from 1,429 deliveries in 2011 to 1,167 in 2012, an 18 percent reduction that far outpaces the 4.5 percent reduction in newborn admissions in Nassau and Suffolk counties during the same period,” Lynam said.  “Based on current market trends and recent decisions by local obstetrics/gynecology practices to refer their maternity patients elsewhere, the hospital is projecting that its maternity volume will decline further this year to about 1,000 – less than three deliveries per day.”

In an act of opposition, medical personnel at the Plainview hospital, including doctors, nurses and midwives recently gathered in nearby Bethpage to express concern over the program’s closing endangering the health of patients in emergencies.

As reported by Newsday, the group met to plan how to stop the closure, and said that losing a maternity delivery center in the Nassau-Suffolk corridor would lead to more babies being delivered on the Long Island Expressway.

According to Laurence Mack, an obstetrician and gynecologist, certain medical complications during the delivery process requires immediate medical attention found in a hospital’s maternity unit.

The group of 11 at the meeting concluded by vowing to reach out to state lawmakers and NY State Governor Andrew Cuomo to apply pressure to the NY State Health Department in stopping the closing.

According to an article that appeared in Womens Enews.org, the number of maternity wards that are closing across the nation are hard to track, however an internet search shows the flashing lights of protests and outcries in numerous U.S. communities.

National Vital Statistics Reports by the Center for Disease Control and Development listed 4.2 million occuring to U.S. residents in 2008, a decline of two percent from the record number reported in 2007, and listed 4.0 million births in 2010 - a 3 percent drop from 2009.

According to PewResearchTrends.org, the U.S. birthrate dipped in 2011 to the lowest ever recorded - National Center for Health Statistics listed preliminary data of 63.2 per 1,000 women of childbearing age.

Michael Fener, the hospital’s executive director, said while the hospital has conducted extensive research to determine the viability of maintaining the hospital’s maternity program, the magnitude of a 30 percent decline in births over three years, and “region-wide data showing the trend will continue,” has forced the hosptial to make “a very difficult decision in closing the program.

Fener also emphasized that the decision to close Plainview’s maternity program was not influenced by financial considerations, and the program currently is profitable. “With the rapidly declining numbers, however, there are concerns about the hospital’s ability to maintain staff competency and patient safety, and run the program efficiently as its census continues to drop,” Fener said.

Closure plans for the hospital’s 15-bed maternity program were filed earlier this month with the state Department of Health.

While its maternity program will close, the hospital will continue to provide a gynecological surgical service and its emergency department will provide ongoing coverage for obstetrical/gynecological emergencies, working closely with our regional referral center and EMS providers to ensure smooth transfers.

All impacted staff are expected to be offered other positions, either in the hospital or in other North Shore-LIJ hospitals.

According to Lynam, the hospital’s decision to discontinue its maternity program was based on extensive research conducted over the past year and analyzed by administrators and physician leadership of the hospital and its parent, the North Shore-LIJ Health System, saying that in 2011 and 2012, all but one maternity program with less than 2,000 annual deliveries in Nassau and Suffolk counties lost volume.

“More women are choosing to deliver their babies at larger hospitals with maternity departments equipped with single-bedded rooms, more-advanced neonatal intensive care units and high-risk specialists,” Adiel Fleischer, MD, chair of ob/gyn at the North Shore-LIJ Health System said.

Lynam has also said deliveries at North Shore University Hospital in Manhasset, NY, and LIJ Medical Center in New Hyde Park, NY, where the system spent $300 million to create the state-of-the-art Katz Women’s Hospitals opened in 2011 and 2012, respectively, “increased a combined 13 percent from 2011 to 2012 to a collective total of about 12,220.”

“With an average birth rate of less than three a day at the Plainview hosptial, it is increasingly difficult to maintain staff competency, raising concerns about the potential impact on quality of care,” said Alan Mensch, MD, the hospital’s medical director and senior vice president of medical affairs.  “Even if the hospital invested millions of dollars to renovate and modernize the hospital’s neonatal intensive care unit, and labor, delivery and post-partum rooms, the physical limitations of the space still would not enable the hospital to provide women and their families with the private rooms that have become standard in most hospital maternity units.”

According to Lynam, hospital and health system physician leaders are working closely with Plainview Ob/Gyns to transition their practices and patients to other North Shore-LIJ hospitals, and in addition to the Katz Women’s Hospitals at LIJ and NSUH, Huntington and Southside hospitals both have significant capacity to accommodate additional patients.

“We know that the staff and the community have strong emotional ties to Plainview Hospital and the maternity program,” Fener said. “Several generations of local families, including our staff members and their relatives, have had their babies delivered here since the hospital was founded in 1961. We are proud of the excellent patient care and service the OB department’s nurses, physicians and staff members have provided to tens of thousands of families over the years.”