Following last week’s closure of the midwife practice at Carolina OB/GYN, a division of Wilmington Health Associates, which abruptly left many obstetrics patients without access to their primary care midwives, a statewide policy organization has turned its attention to the region’s main birthing center: New Hanover Regional Medical Center.

In a letter sent to hospital officials on Friday, the North Carolina Friends of Midwives addressed NHRMC’s policy that requires a supervising obstetrician to be on-site during any labor and delivery attended by a midwife.

“It is our understanding that a key reason why WHA dissolved the CNM (certified nurse-midwives) operation, and why there is an alarming (shortage) of CNMs in the area, is because of this policy that requires the supervising OB to be on-site for all deliveries,” wrote Russ Fawcett, legislative director of North Carolina Friends of Midwives, in an e-mail. 

The letter to New Hanover Regional Medical Center indicated that the hospital’s policy “creates undue burdens on OBs (obstetricians) who collaborate with CNMs.”

North Carolina law requires midwives to have a mandatory supervisory contract with a physician. Although many hospitals including a hospital in Jacksonville, NC do not require the supervising physician to be on-site at the time of birth, New Hanover Medical Center does, Fawcett said.

New Hanover Regional Medical Center confirmed this, but added that the local hospital’s policy is in place for the rare situation when the comprehensive team which includes a physician needs to save the life of a mother and baby, said Barbara Buechler, director of the Women’s and Children’s hospital at New Hanover Regional.

The closure of Carolina OB/GYN’s midwife practice was based on “operational requirements, not financial or quality issues,” said Alysa Bostick, director of physician relations and marketing at Wilmington Health Associates. The private practice, which operated its midwife program for the past five years, declined to confirm whether the hospital’s policy made it difficult to continue.

“Wilmington Health Associates has not consulted with us,” said Martha Harlan, director of public relations and marketing at New Hanover Regional Medical Center. “We have had an active nurse-midwife practice here for the past 10 years. We haven’t changed anything. We have had this policy in place,” she said. Currently, the nurse-midwife delivers about 4 percent of the 4,000 births at the hospital.

“The key thing to keep in mind is that if we had the same access to CNMs that much of the rest of the US enjoys, we would expect that 10% of births would be attended by CNMs,” said Fawcett. “This would translate into over 400 births per year in our region requiring access to 12-15 midwives. With this recent action, we have only one in the region,” he said.

North Carolina Friends of Midwives has requested a meeting with the hospital and its stakeholders to address their concern over the loss of two of the three local midwives serving the community. Hospital administrators have yet to decide to meet with the group, Harlan said.