International support for St. Luke's Birthing Center! Accolades from New Zealand Midwifery expert

7th December 2007

Sara Wickham
With Woman
PO Box 400
Rangiora
New Zealand

To: Dr. Martin Brotman, President and CEO, California Pacific Medical Center

CC: Patrick E. Fry, CEO, Sutter Health
Dr. Mitchell Katz, Director of Health, San Francisco Department of Public Health
The Rt. Rev. Marc Andrus, Member, California Pacific Medical Center Board
Senator Carol Migden

Dear Dr. Brotman:

I am writing to express my support for the campaign to save St Luke's as an acute care hospital. While St Luke's clearly offers valuable services to the local community across the health care spectrum, it is the loss of the two midwifery services and the impact that this will have upon local women and families that gives me particular cause for concern.

I became aware of the existence of The Homestyle Midwifery Service around the time of its inception in 2000. Based on the principles of the midwifery model of care, the Service offers safe, competent and sensitive care to women and their families. Indeed, the success that this Service has achieved in integrating the best of the midwifery model within an acute care setting is recognised and valued not only locally, but nationally and internationally.

As I am sure you are aware, the kind of midwifery care offered by Homestyle Midwifery and similar services has been shown to result in:
• Decreased incidence of maternal hypertension (Blanchette 1995, Tucker et al 1996, Turnbull et al 1996).
• Fewer antenatal hospital admissions (Tucker et al 1996, Fraser et al 2000, Hodnett 2000, Jackson et al 2003).
• Decreased incidence of abnormal fetal heart rate in labour (Harvey et al 1996, Fraser et al 2000, Jackson et al 2003).
• Fewer cesarean sections (Davis et al 1994, Harvey et al 1996, Fraser et al 2000, Jackson et al 2003).
• Less perineal damage (Blanchette 1995, Oakley et al 1995, Harvey et al 1996).
• Fewer or equivalent number of preterm births (Turnbull et al 1996, Fraser et al 2000, Jackson et al 2003).
• Less need for neonatal resuscitation (Hodnett 2000).
• Lower admission rates to neonatal intensive care units (Harvey et al 1996, Tucker et al 1996, Turnbull et al 1996, Jackson et al 2003).
• Decreased or comparable incidence of perinatal death (Tucker et al 1996).

I understand that Sutter Health Care is committed to excellence in health care. I also understand that there are always wider economic and political considerations when decisions need to be made about health care resourcing and management. However, given that each of the outcomes mentioned above leads directly to a reduction in cost as well as an increase in the health, wellbeing and satisfaction of women and their babies, I urge you and your colleagues to reconsider the closing of St Luke's and to look for ways in which you can work with and support this facility, Homestyle Midwifery and other midwifery services locally.

Kind regards,

Sara Wickham, RM, MA, PGCert, BA(Hons)
Independent Midwifery Lecturer and Consultant

Blanchette, H. (1995). "Comparison of obstetric outcome of a primary-care access clinic staffed by certified nurse-midwives and a private practice group of obstetricians in the same community." American Journal of Obstetrics and Gynecology 172(6): 1864-68.

Davis, L., G. Riedmann, et al. (1994). "Cesarean section rates in low-risk private patients managed by certified nurse-midwives and obstetricians." Journal of Nurse-Midwifery 39(2): 91-97.

Fraser, W., M. Hatem-Asmar, et al. (2000). "Comparison of midwifery care to medical care in hospitals in the Quebec pilot projects study: Clinical indicators. L'Equipe d'Evaluation des Projets-Pilotes Sages-Femmes." Canadian Journal of Public Health 91(1): 15-21.

Harvey, S., J. Jarrell, et al. (1996). "A randomized, controlled trial of nurse-midwifery care." Birth 18(4): 260-267.

Hodnett, E. (2000). Continuity of caregivers for care during pregnancy and childbirth, Cochrane Database of Systematic Reviews (2) CD000062.

Jackson, D., J. Lang, et al. (2003). "Outcomes, safety and resource utilization in a collaborative care birth center program compared with traditional physician-based perinatal care." American Journal of Public Health 93(6): 999-1006.

Oakley, D., T. Murtland, et al. (1995). "Processes of care. Conparisons of certified nurse-midwives and obstetricians." Journal of Nurse-Midwifery 40(5): 399-409.

Tucker, J., M. Hall, et al. (1996). "Should obstetricians see women with normal pregnancies? A multi-centre randomised controlled trial of routine antenatal care by general practitioners and midwives compared with shared care led by obstetricians." British Medical Journal 312(7030): 554-59.

Turnbull, D., A. Holmes, et al. (1996). "Randomised controlled trial of efficacy of midwife-managed care." British Medical Journal 348(9022): 213-218.