A baby born at Fairview Hospital in Great Barrington under the care of a midwife in 2017. CHP ended its midwifery program at the hospital last week, and women will now have to travel to Pittsfield for the care of a midwife.
GREAT BARRINGTON — Women in South County who want the services of a nurse midwife will now only be able to find them in Pittsfield.
Community Health Programs this month ended its nurse midwife service through Barrington OB-GYN and Fairview Hospital, and laid off the midwife, citing several reasons.
The move concerns a longtime area midwife. She says people in the area embrace a more holistic approach to birth and points to research that indicates women in childbirth fare better with midwifery care.
CHP says the number of deliveries at Fairview was low and that more women require additional medical intervention with births. And with an aging population, there is greater need for complex gynecological care and surgeries, said Dr. Andrew Beckwith, an OB-GYN in the Great Barrington practice who was appointed last month as CHP’s chief medical officer.
He said the practice had a hard time keeping midwives on its staff. They weren’t always available for deliveries – especially with just one nurse midwife.
For several months, CHP weighed whether to end the service, Beckwith said. “CHP has been biting the bullet to make it work for a number of years and now we had to reassess,” he said. “A confluence of things didn’t make it doable anymore.”
The decision was made knowing there is still a local option at Berkshire OB-GYN at Berkshire Medical Center, home to what Beckwith termed “a very robust nurse midwife program,” with five midwifery practitioners, according to the website.
The Great Barrington service ran for years, starting before CHP took over the practice in 2007. A longtime nurse midwife, Linda Baxter, retired in 2014 and no one took her place. In 2018, CHP hired midwives again, and at one point there were three.
GREAT BARRINGTON — Two South County medical establishments are bringing a certified nurse-midwifery program back to the area following a three-year hiatus. Community Health Programs and Fairview Hospital are collaborating to bring two certified nurse-midwives to CHP Barrington OB-GYN, South County's obstetrics and gynecology practice.
Fairview Hospital typically sees 130 to 150 deliveries per year, Beckwith said. To cover costs, one doctor, as a general rule, needs to deliver more than 70 babies per year. In 2021, deliveries rose above the norm in a one-off, Beckwith said.
With an older population, the office is performing more complicated gynecology and various surgeries. For this reason, the practice will likely hire another OB-GYN who can handle a variety of care, Beckwith said.
Susan Greenberg-Yarmush, the nurse midwife who was laid off, did not respond to a message seeking comment.
Views of the change
Molly Rivest, a CHP nurse practitioner, said that while limiting a woman’s choice for her birth care is “problematic,” she said Great Barrington OB-GYNs tend to work in a more holistic way because they have worked with midwives.
“Because that’s what the community generally is asking for,” Rivest said. “It’s important for them to focus on womens’ choice. I am hopeful that CHP will ask the community — women or people who identify as female — what sort of care they want.” Rivest said she is leaving CHP for unrelated reasons.
Baxter, the retired, longtime nurse midwife at the practice, said she worries about the fallout of CHP’s decision.
“What worries me is that all the births will be more medicalized,” Baxter said.
She cited research that shows care from midwives can make births safer. The U.S. has a cesarean section rate significantly higher than what is considered healthy.
Baxter says she believes ending the midwife service runs counter to the philosophy of federally qualified health centers like CHP.
“They should be very patient-centered and holistic,” she said, adding that women in South County have few choices of medical care as it is. “A lot of women in the area want care from midwives.”