Update: SSM Health announced on 10/7 that they will not be ending the midwifery program.
Late last week, SSM Health leaders decided to end their midwifery program at the end of 2021. The Cap Times reports that leaders cited low demand for in-house midwives, and said they would provide access to midwife services through community partners. Still, the decision would leave about 100 pregnant patients to search for new midwives, and the hospital’s midwives out of a job. After days of backlash, SSM Health announced that the program would continue until a sustainable model is in place.
Melissa Pfahl gave birth to her first baby last year with the midwives. She started her pregnancy with an SSM obstetrician, but later switched. She says the time and care the midwives were able to give her was what she had wanted for her birth. “This is a really unique program that they have to have midwives in the hospital. It is true, that many women choose to have midwives in the birthing center or in the home birth, but I think having midwives in the hospital really opens up a lot of opportunity to break health disparities in the community, especially in Madison,” she says. “I just think like those four women really put so much care and so much energy into their patients.”
Claire Baker is a doula in Madison. She is 24 weeks pregnant with her first baby and a patient of the SSM midwives. She was planning to have a home birth, but had to pivot due to health concerns. “Then to also find out that my hospital-based midwives were maybe not going to be an option, it was just feeling like a lot of choices were being taken away from me in a really short amount of time,” she explains.
Baker is planning to stay with the midwives until her birth. She had an appointment with the midwives today where they said they will update her regularly, and she now has a backup OB in case the program dissolves before her baby is born. However, Baker is less sure she will stay with SSM Health in the future. “It feels like the decision was made in a silo, without really, including people who are on the ground and know what the needs of the community are,” she says. “I think it’s just made it very clear where their values are.”
Lauren Brockman says her wife is 7 weeks pregnant. She says they were excited to go back to the SSM midwives for their second child. “As a lesbian couple in this community, you know you don’t you don’t walk into St Mary, and feel super welcome,” she elaborates. “You know, having Emily with us saying ‘this is her wife, this is not her sister, this is not her friend.’ She was such a great buffer for us. So I did not need to explain 30 times who I am because I’m just as much a mother to our daughter as my wife is and so that was so important to us.”
Katie Rice is a doula in Madison. Rice sees her role as a doula as a person who provides mental, emotional, and informational support to pregnant people. She says that people should have access to a midwife if that is what they want, regardless of their financial status. “This person walks into their birth, having dreams and expectations and hopes for how it goes,” she shares. “We know that midwives provide holistic evidence based care. And so, it should be available to those who want and need it. This program makes it possible, especially for those who might not be able to pay out of pocket for someone who provides midwifery services in people’s homes, and not in the hospital.”
Jennifer Aumanstal is a labor nurse at St. Mary’s and has worked with the midwives since the program started. She just actually became a certified midwife herself–something she credits the SSM midwives with making possible. Aumanstal says that the midwifery program can do a lot for families in Madison. “To take this as an option, away from families who are wanting to have midwifery care, and don’t have an option,” she says. “It’s so disheartening to me, especially when we’re trying to focus so heavily on birth inequity and the differences in outcomes for black women compared to white women, and we know that midwifery care can bridge that gap and help provide better outcomes.”
A 2018 study by the American College of Nurse-Midwives finds that among women with low-risk pregnancies, midwifery care is associated with more positive health outcomes. That could help reduce disparities, in a county where Black mothers are three times more likely to die in pregnancy than white mothers.
According to data from the CDC, Wisconsin has the highest Black infant mortality rate in the nation. And a 2019 report finds that in Dane County, Black babies die at least double the rate of white babies. Black babies are also twice as likely as white infants to have low birth weight. Public Health Madison Dane County, which issued that report, attributes that to social and economic challenges caused by discrimination and structural racism for Black mothers.
Last year, a protest led by local Black doulas highlighted these disparities in care and outcomes. Speakers described their experiences as Black women receiving care at Madison hospitals, including at St Mary’s Hospital, which is operated by SSM Health. At the time, St. Mary’s Hospital President Kyle Nondorf said he was committed to mitigating racial disparities.
SSM Health responded to WORT’s request for comment by saying an update on the situation is expected tomorrow.
A protest to save the midwifery program is scheduled for 3PM this Sunday at St. Mary’s Hospital.