After nearly nine years of providing midwifery service at Hudson Hospital, Hudson Physicians is ending the program effective Aug. 1.

The decision is based on financial and resource reasons, said CEO Matt Brandt. It's one made solely by Hudson Physicians, which partners with Hudson Hospital but is a separate entity.

"Financially we have never been able to make it work," Brandt said.

Each delivery by a midwife also has an OB-GYN assigned to it, which means the program is doubling up, Brandt said. The volume of deliveries is not high enough to sustain the program, he said.

In its nine years the midwives have cared for 984 patients, and are expected to exceed a thousand by the time the program ends. The midwives have had 848 catches, meaning the babies were born into their hands, said Elizabeth Radford, Certified Nurse Midwife. The rest of that number includes high-risk delivery such as cesarean, a patient that was transferred, or a delivery when Radford was the only midwife and on vacation.

The obstetrics program is made up of five OB-GYNs, the three midwives and one nurse practitioner. Together they total 660 deliveries in a year.

That amounts for more than 80% of the possible deliveries in the area, Brandt said. With that much of the market covered, he said it was unlikely the program would be able to grow to a level that would be able to sustain the midwifery service.

"We would have to draw people from further away," he said.

The decision had nothing to do with the quality of the midwifery service, Brandt said. The program has received awards for quality.

"The tough part is, it was a really good program," he said.

The midwives have stopped taking new patients, and an Aug. 1 end date was set to finish delivery with current patients.

Providing care

Hudson mom Sara Capecchi delivered with a Hudson Physicians midwife in 2018, and was disappointed to hear the service was ending.

"From the first meeting to all the prenatal care to the labor to the birth to the postnatal care it was a phenomenal experience," Capecchi said.

She started a petition to "let Hudson Physicians know that eliminating the midwifery service will have a devastating effect on the quality of care offered." The petition has received more than 2,600 signatures.

Brandt said it's good news that so many people were passionate about the service midwives provided. Volume, however, is still an issue.

"If there were that many people coming we wouldn't have that issue," he said.

Capecchi said giving birth is an emotional experience, and women should have the choice of how they do it.

The Hudson Physicians midwives are certified nurse midwives, Radford said. This certification requires either a masters or doctorate in midwifery along with national certification and state licensing. Radford herself became an RN and worked for four years before attending the University of Minnesota for midwifery.

The care midwives provide is more individualized, Radford said.

"Midwife literally means with woman," she said.

Midwives work to understand what's happening with their patients not only physically, but socially, spiritually and in other aspects of their lives, Radford said. They are with patients through active labor as much or as little as the patient desires.

The midwives also provide a continuity of care that develops a relationship. Midwives offer services beyond pregnancy and birth, including well woman checks.

Capecchi said the decision to end the program limits the options in Hudson.

"People that are seeking out a midwife birthing experience, they're not going to be able to birth at Hudson anymore," she said.

Without the option of a midwife, Capecchi said Hudson Physicians is missing the whole picture of women's wellness.

The services offered by midwives will still be available, Brandt said. OB-GYNs will still offer water births and vaginal birth after cesarean (VBAC).

RNs at Hudson Hospital will do more of the labor process now, OB-GYN Dr. Jon Susa said.

"We didn't diminish any of our services, we just changed who's performing them," Brandt said.

Still Brandt said it will be hard to duplicate the level of service midwives delivered.

"We're going to do everything we can to offer same or similar services," he said.

Capecchi said she feels the decision shows they don't understand what a midwife does. She said an RN is not a midwife and doesn't create the same experience.

"It's evident they don't get it," she said.

Susa said they still appreciate the midwifery service and what it offers to patients. If patients are interested in delivering with a midwife, he said Hudson Physicians will refer them to options, and there will be no hard feelings if that's what they choose.

Susa said they greatly appreciate the work of the midwives.

"We still value the time and the energy and the patient care that they did," he said.

Capecchi said her main goal is to show the midwives how much the community appreciates them.

"How much we have loved birthing with them and that they've created such a unique and amazing experience for us. We really can't thank them enough because delivering a baby is really such a personal experience," she said.

Capecchi said she also wants Hudson Physicians to know that the community is disappointed in the decision, she said.

Continuation at new location

All three midwives have signed contracts to work at Minnesota Women's Care. Dr. Melvin Ashford said the center's model is based on collaborative practice between midwives and obstetricians.

"It's essential," Ashford said. "They bring an important component."

Ashford said center staff were a little shocked to hear the Hudson Physicians midwifery program was ending.

"The next thought was, 'Hey, why don't we hire them?'" he said.

Ashford himself just moved to Hudson a few weeks ago, so now has a greater connection to the area.

"We love midwives and we think they'd be a great addition to our practice," he said.

The midwives will work out of Woodbury, though Ashford said the center is looking into a Hudson office.

Ashford said they want to provide an opportunity for Hudson patients to continue with the midwives. They will continue to see the same care they have come to respect and love.

"Hopefully it's not an ending, but rather a continuation at another location," Ashford said.