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November 16, 2023

Report: Maternity care in North Worcester County was poor before Leominster closure

PHOTO | Courtesy Google Maps UMass Memorial HealthAlliance-Clinton Hospital in Leominster

The healthcare landscape in North Central Massachusetts faces detriments in prenatal care and median distance to hospitals with comprehensive services, according to two Thursday reports from the Massachusetts Executive Office of Health and Human Services. 

As community advocates were pleading with her to prevent the September closure of the birth ward at UMass Memorial HealthAlliance-Clinton Hospital in Leominster, Gov. Maura Healey ordered the two state reports focused on health outcomes, health equity, and access to specialized care, including nutrition services, doulas, and mental health supports. The reports released Thursday found while there are no maternal care deserts in the state, challenges continue related to transportation and staffing, and concern persists about access to care in the North Central region.

The two reports, North Worcester County Area Essential Services Review and Review of Maternal Health Services, focused on health care in the North Central Massachusetts region and maternity care the state overall. 

Following the closure of the Leominster maternity ward, there are only 11 maternal/newborn beds in the North Worcester County area, according to the report, and there is cause for concern that the closure of the ward will impact access to prenatal care.

While the closure of birthing services in Leominster did not eliminate prenatal services from the hospital, only three towns in North Worcester County – Townsend, Winchendon, and Sudbury – had more than 90% of births in 2022 where there was adequate prenatal care services. Access to those prenatal services was poor among communities surrounding Leominster even before the closure, according to the report.

Between 2011 and 2021, the distance required for travel to a birthing center increased in several North Central communities, from 5-10 miles to over 15 miles, according to the report. Six communities in the region were specifically highlighted as communities where the distance traveled to a birthing facility increased by more than 10 miles over that 10-year span: Leominster, Fitchburg, Gardner, Westminster, Ashburnham, and Templeton.

Statewide, the maternal health report found Massachusetts does not have maternal care deserts, defined as areas with no hospitals providing obstetric care, no birth centers, no OB/GYN, and no certified nurse midwives, according to national advocacy nonprofit March of Dimes. Throughout Massachusetts, 39 hospitals provide labor and delivery services, but that number is down from 51 in 2014.

At the time of the closure of the ward at the UMass Memorial Health hospital in Leominster, advocates urged Healey to issue a stay to keep it open. The report did not make a suggestion to reverse the September closure, nor did it condemn the closure in any way. The report did recommend a review of the essential services closure protocol to better protect patient safety.

The maternity report recommended the establishment of a statewide Fetal Infant Mortality Review Committee to better collect data and more telehealth options and remote care, including remote blood pressure monitoring. 

The North Worcester County report, which focused on broader health care and not just maternity care, found limited options for both inpatient and outpatient mental health and substance-use disorder care, as well as general workforce challenges and transportation difficulty. The report recommends continued listening sessions hosted by the Massachusetts Department of Public Health with the community and a push for workforce development, as well as increasing behavioral health beds in the region. 

“These reports alone are not the solution to ensuring access to maternal health care and essential services,” Lt. Gov. Kim Driscoll said in a Thursday press release accompanying the reports. “They are an important step in the ongoing work of our administration – in collaboration  with our communities – to ensure that all our residents can benefit from the world-leading health care we have available in Massachusetts.” 

The Massachusetts Nurses Association, a Canton-based labor union and advocacy group, called for a more thorough region-by-region review of maternal care in a Friday statement responding to the reports. The MNA was among the groups trying to keep the ward open.

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