The story of the termination of seven midwives (six midwives and one nurse practitioner) at Northern Manhattan’s New York-Presbyterian (NYP) Allen Hospital is still puzzling for the workers it will soon be impacting.
Just this past November, the midwives said they were in a meeting with Dr. Cassandra Simmons, NYP Allen’s interim chief of service. Dr. Simmons reportedly told the group about hospital plans to expand its midwife services in the obstetrics and gynecology department; Simmons had said that there were even plans to hire more midwives.
The hospital initiated its midwifery services in 1965 but for the past several years, its national and state licensed certified nurse midwives were primarily doing triage of patients, postpartum care, and occasional vaginal deliveries.
“Our primary roles have been triage and postpartum,” said an NYP Allen midwife who spoke anonymously with the AmNews. Dr. Simmons had told the midwives there were plans to give them more labor management and delivery responsibilities. “So, we responded that that sounded exciting; we were happy about the prospect,” the midwife recalled. “And then, two or three weeks following that meeting, we each received an email that our service was being closed, as of February 1.”
On December 4, 2023, NYP Allen sent out letters to its midwife services staff. The subject headline for the letter was “Allen Midwifery – Program Elimination,” and continued with, “This letter is to inform you that the Hospital will be eliminating your position, as a Nurse Midwife, at the Allen Hospital. This elimination is scheduled to become effective on or around February 1, 2024.
“Should you choose to remain at NYP, we will work with you to secure another position at the Hospital. A meeting will be set up with you and your representatives to discuss these changes and potential impact to you. We will contact you shortly with those details.”
The midwife eliminations were later rescheduled and are now set to take place March 3, 2024.
Since that staff termination letter was sent out, the midwives said they have had many meetings with management but no one from New York Presbyterian or its affiliate, Columbia University, has explained why the hospital’s midwife program is being eliminated. “Nobody ever mentioned that care, proper care, was not being provided. Nobody mentioned that we, as the particular midwives…had any issues. None of us had any meetings about [our] performance. They just… there’s been no explanation.”
With no feedback from management, the midwives said they were confused about what had just happened. Then New York State Nurses Association (NYSNA) union reps came across a new job posting from Columbia: they were searching for midwives. The job description was the same as the one that had been discussed at last November’s meeting. It looked as if Columbia was reconstructing the midwifery services program that had been planned but was being shut down at NYP Allen. The job posting described any new hires as doing “work under the supervision of the attending physicians to provide full-scope management of care to low-risk obstetric patients.”
None of NYP Allen’s midwives have applied for the Columbia job. “The majority of us are either close to retirement, within a few years of retirement, or within a few years of being vested in the pension. So, just from a practical matter, to leave NYP at this point would be a major financial loss for us and our families,” the anonymous midwife said. “For the others of us for whom that was less of a concern, we have felt just that the process was undertaken in such bad faith and to go and work under these circumstances when we feel, you know, deceived and undermined and lied to … it just felt impossible to take this job that they’re building.
“They had a midwifery service, they’ve dissolved it, and they’re building a new midwifery service from scratch without the input of the midwives who have given, in many cases, the majority of their career [to the hospital] is just… it’s so disrespectful…
“I think the confusing thing is, you know, we are there three days a week, we’re there 40 hours a week, and nobody speaks to us about any of this. Our direct manager hasn’t informed us what’s going on. … The nurses don’t know what’s going on. The doctors don’t seem to know what’s going on. So, it is certainly possible that they will build a midwife service, but, typically, these things take time. Typically, to hire a bunch of new midwives––all new––to an institution, all at once, is very unusual. It usually builds slowly…if they had kept on the seven of us and then hired a few more and everyone would have been integrated and oriented properly to the service, that would have been a recipe for a great midwifery service. I’ve never really heard of a midwifery service just being created from scratch by doctors before from an institution that’s typically been pretty hostile to midwifery. So, I do hope for the community that they continue to have access to midwifery care, but … it’s just such an unusual way to go about it that I’m just concerned about how it’s going to function.”There is currently a Change.org petition calling for the reinstatement of all NYP Allen midwives