New York City offers a buffet of choices for women — a nail salon on every corner, any number of hairdressers or clothing stores. Even medically, we have options: If you have a lump in your breast, you can choose from the best hospitals in the country, maybe even the world. If you desire breast implants, the best surgeons are at your disposal.
Yet strangely, if you’re having a baby, the choices about what kind of setting and where you’d like to deliver is extraordinarily limited in New York. And they’re about to shrink further.
For years, Mt. Sinai West (formerly St. Luke’s Roosevelt) has operated a birthing center on a hospital floor in an attempt to replicate the feel of a home birth while offering a team of doctors and, if necessary, an operating room nearby.
Yet last week, hospital brass told staff the center would be closing at the end of the year so Mt. Sinai could expand its labor and delivery floor and its neonatal facilities.
The Mt. Sinai birthing center’s closure is an enormous loss for women in the city. It will leave just one in-hospital birth center here, at New York-Presbyterian’s Lower Manhattan Hospital. And that one has only two rooms available for delivering moms — that is, two rooms for every single woman in New York City looking to have an in-hospital birth-center experience.
Birth centers, especially those in a hospital setting, provide a happy medium between a home and a hospital birth for low-risk women. The mothers who decide to give birth in a birth center want the safety of being near medical professionals but don’t want a medicalized birth with unnecessary wires, tubes or other devices restricting movement, or an epidural, or the mere feeling of being in a hospital at all.
For pain relief, women can instead enjoy hydrotherapy in a jacuzzi and the ability to walk around freely. Hospital birth centers work to make women forget they’re in a hospital in the first place.
The rooms in Mt. Sinai West offer women a full-size bed, a jacuzzi for laboring and the ability to stay in the same room in which they give birth after delivering. The birth center is decorated like a home, with quilts on the bed and a wooden rocking chair at the foot of it. But this isn’t just about aesthetics: Women who feel safe and comfortable often have an easier time getting through labor.
A paper for the Journal of Perinatal Education explained, “In nature, when a laboring animal feels threatened or disturbed, the stress hormone catecholamine shuts down labor. Similarly, when a laboring woman does not feel safe or protected or when the progress of her normal labor is altered, catecholamine levels rise and labor slows down or stops.”
This idea, that women should feel safe and protected and that doing so benefits their own health, is at the heart of midwifery care, and it’s why women choose it. With the elimination of the Mt. Sinai birth center, the midwifery model of care in a hospital setting is now even more rarefied.
A writer on a post at the mommy blog Mommy Poppins, which profiled a number of different birth centers, noted that tours of Mt. Sinai’s center by expectant women were “crowded.” These women represented hundreds of New York mothers who are seeking a lower level of intervention during delivery and who now all have just the two rooms at Presbyterian to compete for. That suggests the demand for such centers may be significant.
For whatever reason, these women don’t want an actual home birth, yet if those two rooms are unavailable for them, they’ll be forced to decide between just that and a more traditional, medicalized hospital birth.
“We now see one more choice taken from women who are desperately searching for choices in a broken system,” the advocacy group Choices in Childbirth said, following the Mt. Sinai West news. “Low-risk, low-intervention birth in the US is not rewarded financially.”
This wouldn’t be as much of a problem in rural or even suburban America; after all, there are only so many new mothers every year in those areas. And, yes, it’s true that not everyone can get what they want all of the time.
But in New York, the city where you can get any cuisine imaginable delivered to your door at any hour, there should be any number of ways for mothers to have the safe birth experience of their choosing, especially when it involves merely being left to labor without unnecessary medical intervention. Alas, the options for mothers have just gone from bad to worse.
Bethany Mandel is an editor at Ricochet. Twitter: @bethanyshondark
