The Missoula Birth Center, reeling in the wake of the sudden death late last year of its founder and driving force, Dr. Lynn Montgomery, is in negotiations with Community Medical Center for a sale, partnership, or other arrangement. Both organizations confirmed the talks and a deal could be reached as early as this week.
Since Montgomery died suddenly of a heart attack in October at age 51, concerns about the future of the center have been rippling through the community, especially among its patients.
Gia Randono is one of about two dozen Birth Center patients who over the past few months have been circulating petitions and writing letters asking either St. Patrick’s Hospital or Community Medical Center to help keep the Birth Center in operation. The Birth Center and Community Medical Center are the only facilities in Missoula with dedicated labor and delivery rooms.
“It would be so unfortunate to lose not only Dr. Montgomery but also the birth center,” Randono says. “It was still developing. There was so much potential there.”
Montgomery, an OB/GYN with training in high-risk pregnancies, came to Missoula in 1998 and started the Birth Center in 2006 with a vision of, as described on the center’s Web site, “an alternative and safe birthing experience for women with normal, healthy pregnancies opting for no intervention or medication.”
At the Birth Center, mothers labor and deliver in one of two birthing suites, which feature candles, flower arrangements, and electric fireplaces; patio doors open onto an outdoor walkway; and private bathrooms include easy-access showers and toilets with heated seats. At its peak the center, which also offers pre-natal and general women’s health care, was seeing about 75 patients per day.
Since Montgomery’s death, however, the number of patients has dwindled to around 25 per day, and the center has cut its staff from 16 to six. A temporary arrangement with another OB/GYN allows births to continue at the center for the time being, and new patients are still being accepted. But — absent a doctor able to replace Montgomery full time — it seemed doubtful that the Birth Center could continue to operate as before.
Neither the Birth Center nor Community Medical Center could comment on specific difficulties the Birth Center faces, but Kate Bauer, the executive director of the American Association of Birth Centers, shed some light on the various issues facing birth centers nationwide. Profit margins at birth centers are tight, due to skyrocketing malpractice-insurance costs. Also, while studies have shown birth-center deliveries to be safe, the idea of non-hospital births continues to struggle for acceptance among some medical professionals. “One of the obstacles to physicians working in birth centers can be the political climate in the medical community,” says Bauer. “If a doctor works with a birth center, will it be harder to work with other doctors in the community? Will it be harder to get hospital privileges? We don’t think of medical care as having politics, but it does, just like any business.”
As awareness of natural child birth builds, birth centers like Montgomery’s have come into new demand. The reasons vary greatly from mother to mother, but—according to the pregnancy book Great Expectations, which does not advocate any specific birthing option—births at hospitals cost on average two to five times more than at birth centers (at the Missoula Birth Center, deliveries cost about $3,200). Also, hospital births are more likely to involve forceps and vacuums or end in c-sections; mothers who give birth in hospitals are more likely to suffer post-partum depression or post-traumatic stress disorder; hospital shift changes mean the mother may encounter different staff members during her labor and delivery, increasing the chances that her birth plan may not be honored; and delivery rooms are not always designed to accomodate multiple family members.
For Randono, who had her first child in a hospital, the Birth Center experience was a marked change. “My midwife and nurse were there throughout my delivery,” she says. “There was natural light. It felt so good to be able to labor and deliver in a place that felt comfortable.”
“The whole atmosphere was very warm,” agrees Barbara Hall, a Missoula mother whose November delivery was the Birth Center’s 200th. Hall, a first-time mother, says she chose the Birth Center because she worried about giving up control of her delivery. “Women need support if they want to do natural childbirth,” she says. “I was afraid I might not get that support in the hospital.”
Hall says the Birth Center offers Missoula mothers an important and needed alternative. “If I lived in a place where there wasn’t an option like the Birth Center, I might feel like it was a place where I didn’t belong,” she says. “If someone wants to deliver in a hospital, that’s fine, but I really want the option to deliver naturally in a safe environment.”
Michelle Burton, another mother who has delivered at both Community Medical Center and the Birth Center, is even more emphatic. “If I have more kids,” she says, “and I can’t deliver at the Birth Center, I would feel forced to have the baby at home.”