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In response to the ban, several of Hebl’s past and present patients have been lobbying hospital officials to reverse their decision. Hebl says that there have been some positive developments.

New Missoula Birth Center is Birth Ready, But Hospital Ban Poses Problems

Ever since Missoula’s first birthing center closed last January, I’ve been watching with interest the efforts of Jeanne Hebl, a certified nurse midwife who worked there, to open a new one. Now, those efforts are finally looking successful, but a rift between Hebl and Community Medical Center has thrown another curve ball at Missoula parents interested in midwife-supported natural birthing.

Missoula’s first Birth Center opened in May 2006, but the November 2008 death of its founder, Dr. Lynn Montgomery, yanked the rug from under it. No other doctor was willing to permanently take over Dr. Montgomery’s role, and—without a supervising OB-GYN with admitting privileges at Community Medical Center—the first Birth Center was no longer able to provide birthing services to mothers who preferred to deliver in a hospital.

Deprived of this vital revenue stream, the Birth Center’s business model was no longer viable. Dr. Montgomery’s widow leased the practice to Community Medical Center, which promptly discontinued offering birthing services there.

Since then, Hebl has worked to restore a Birth Center-style facility to Missoula. After about a half year in an intermediate space that was too cramped for a birthing room—restricting Hebl to offering only prenatal care and home-birth services—Hebl opened a new Birth Center at 2404 39th Street in early October. Last week, I learned that her staff had completed work on one of two planned birthing rooms, so I stopped by to take a look.

“We’re carrying on the philosophy of the old Birth Center,” Hebl told me as she proudly showed off her new facility’s first birthing room, which is designed to look more like a bedroom (or, really, a high-end hotel room) than a medical setting. A large bed, a gas fireplace, a rocking chair, and plenty of natural light all contribute to the homey atmosphere, and a spacious bathroom with a big birthing tub is readily accessible at one end of the room.

No one has delivered yet in the new birthing room, but Hebl tells me that the first likely candidate is fast approaching her due date, so the room could receive its inaugural use any day now.

This brings us to Hebl’s recent rift with Community. While most mothers who begin their deliveries at a birth center finish there, some end up transferring to a hospital (usually for non-emergency reasons, such as changing their minds about receiving an epidural). Naturally, if one of Hebl’s patients transfers to the hospital, she will want Hebl to come with her, but—in early October—Community Medical Center banned Hebl from its premises under threat of arrest.

Even before the ban, and ever since the closing of the old Birth Center, Hebl had operated in a grey area when accompanying patients to Community Medical Center. Like at most hospitals, Community Medical Center’s labors and deliveries are supervised by OB-GYN doctors. These doctors accept legal responsibility for various aspects of the delivery; in turn, they are allowed to authorize people such as certified nurse midwives to provide medical services for the laboring mother, up to and including catching the baby.

Before last winter, Hebl received this authorization from Dr. Lynn Montgomery, the founder and head of the first Birth Center. After Dr. Montgomery’s death, another Missoula OB-GYN provided authorization on a temporary basis, but that arrangement ended with the closing of the first Birth Center.

Ever since, any time that Hebl has accompanied a patient to the hospital, it has been as an invited guest of that patient, with a status similar to that of a family member or doula. As a result, Hebl was limited in the services she could provide.

“Mainly I was there to support patients and advise them about the choices they have,” Hebl said. “The extent to which I could do that depended a lot on which nurses were present. Some of the nurses there are very open to whatever the patient wants, while others can be less flexible. I guess some of them must have felt like I was crossing a line, although no one ever told me where that line was. I wish they would have discussed it with me before cutting me off.”

In response to the ban, several of Hebl’s past and present patients have been lobbying hospital officials to reverse their decision. Hebl says that there have been some positive developments, though she can’t yet comment on any specifics. An email requesting comment for this article from Community’s Chief Medical Officer, Dr.Jonathan Weisul, has so far gone unanswered.

“Unfortunately, I need them a lot more than they need me,” says Hebl. “I guess we’ll just have to wait and see, but I’m hopeful we can reach an agreement that puts the patients first.”

The new Birth Center is at 2404 39th Street. The phone number is 406-541-7115.

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About Sutton R. Stokes

Comments

  1. Samantha says:

    The birthing room looks beautiful. Congrats, Jeannie, and I hope everything turns out well with Community!

  2. Leigh says:

    Hurray for the new birth center! And for anyone that doesn’t know, Jeanne is having an open house the evening of November 20th, so if you want to see the facility, that’s the time to do it.

  3. Bonnie Koopman Ledford says:

    What legal grounds does the hospital have for banning her? Sounds like she needs a legal defense fund to fight that. That is just outrageous. May the birthing mamas and nurses of Missoula support women’s freedom of choice in birth and help keep the birth center option alive.

  4. Jim Fuge says:

    The hospital is incorporated and charged by the state with the health and safety of the patient and controls access to those patients by limiting access to certified providers only, in Hebl’s case to gain access she has to have an overseeing physician. Dr. Lynn Montgomery’s death removed that access.(click on the ‘banned’ link embedded in the article) Their heavy handed eviction of her from the entire grounds is a turf war. Now any doctor who is willing, has to risk their practice, up their insurance alienate their working hospital environment, and step into a hornet’s next of controversy,…is it worth it? Go get a medical degree yourself and then ask yourself do I want to risk it to be ‘the good guy’.
    The fundamental problem is that we as a country have abdicated the health of our coumunities to profit first rather than health first. Therefore we face these absurd gate guarding
    false choices between midwives and hospitals. Of course doctors and mid-wives can and should work together.
    Many other countries who show much lower infant mortality rates than the US in the world have more than adequately solved this problem, they don’t let insurance or medical corporations run their healthcare systems for profit FIRST. Foxes guarding the chickens comes to mind.
    Where we as country put our priorities and whom we allow to control the healthcare system determines the outcome.
    We don’t have a healthcare system in the US,…we have a wealthcare system, disguised as a healthcare system, and it IS sick.

  5. Jeanne says:

    I’d definitely contribute to a legal defense fund for Jeanne Hebl!

    I’m super pleased that she’s opened her own birth center in Missoula, I think there will be much support.

    My third daughter was born in 1980 at birth center in Pasadena, CA (tho I lived in little town of Crestline in the San Bernardino Mountains which was 60+ miles away)….the experience was fantastic!