UMass Memorial Health plans to close the maternity unit at its Leominster hospital on Saturday, after months of protest, debate, and community uproar.
In a memo sent to employees on Thursday, Dr. Eric Dickson, chief executive of UMass Memorial Health, said the system received a response from the state that acknowledged the closure and the hospital’s plan to mitigate its impacts.
“Closing a service that has been a part of the fabric of the community isn’t easy — in fact, it’s heartbreaking,” Dickson said in the memo. “Keeping a birthing center open without adequate obstetrical coverage is not in the best interest of our patients and is something we are not willing to do.”
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The hospital said it needed to close the unit because of staffing shortages. Protesters pointed out that it was the state’s 11th closure since 2010 and said it would imperil the lives of mothers and infants in the community.
Activists and local officials had hoped Governor Maura Healey would step in to halt the closure. Healey did visit the birthing center and talk to staff, and a spokesperson from her office said Wednesday that the governor was reviewing the situation. However, the governor’s office said on Friday that the administration cannot mandate that the center remain open.
“The fact that the Department of Public Health, that the governor, is unable to do anything to stop this, knowing there are serious concerns and serious safety concerns for people in our community, our most vulnerable, it’s unbelievable. And it’s heartbreaking,” said Eladia Romero, co-chair of Community United to Save Our Birthing Center coalition, and a board member with the Spanish American Center.
The Department of Public Health had determined in August that the hospital’s maternity services were essential and asked for plans to maintain them after the closure. The hospital promised it would continue to provide access to the services by setting up transportation for patients to its flagship campus in Worcester and to other area hospitals. Earlier this month, the Department of Public Health deemed the plan insufficient and asked UMass to consider delaying its closure.
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Hospital officials responded with more details, saying they had finalized the transportation plans, including 24/7, curb-to-curb assistance for non-emergency birthing patients who have difficulty traveling to one of the other four area hospitals with birthing centers, a service it would maintain for at least three years. The health system also discussed its ability to accommodate additional patients at its Worcester hospital and the ability of the surrounding hospitals to do so.
State officials said the response clarified that the hospital didn’t have sufficient staff to continue to operate the unit safely after Sept. 23, saying, “In these circumstances, DPH has determined it will now focus on monitoring and enforcement related to the implementation of the closure plan.”
The closure will progress over the objections of numerous local and state officials, as well as local pediatricians, the Worcester NAACP, and the March of Dimes, a nonprofit focused on maternal and newborn health.
On Friday, the City of Leominster filed a suit in Worcester Superior Court against the hospital, health system, and the Department of Public Health, saying DPH never issued a written decision on whether UMass’s plan preserves access for patients in the region. An attorney for the city said the limited response the state did provide to the health system was insufficient. The city has asked for a temporary restraining order, which can last no longer than 10 days, to delay the closing.
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The health system said it would not comment on pending litigation but that it would not be able to safely staff the unit after Saturday.
”Based on this, we believe the most clinically appropriate course of action is to close the unit and keep it closed,” the health system said in a statement.
In a statement, DPH said that it had followed the law but could not mandate the center remain open.
”We recognize that this is a very difficult situation for all. But if the birthing unit cannot be operated safely, then we must not allow patients to be put at risk,” the agency said.
While Healey could not intervene in the closure, she did order two reviews on Friday to ensure Massachusetts residents, particularly in rural and underserved communities, have access to health care. One review will focus on health equity and health outcomes, including access to specialized services such as doula care and mental health care. An additional review will focus on regional access to essential services in Northern Worcester County, in the wake of the Leominster closure.
Both assessments are to be completed by Nov. 15.
UMass Memorial said a total of 39 caregivers will be affected by the closure. Of those, eight nurses have taken other positions with the Leominster hospital and two surgical techs have moved into other positions. Fourteen nurses and two surgical techs chose to receive severance. An additional 13 per diem staff will be laid off.
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The unit will close at midnight Saturday. Hospital officials said as of Friday there were one mom and baby in the unit, who they expected would be discharged Saturday. If other patients arrive before Saturday’s closure, a hospital spokesperson said staff would assess their clinical status and determine the course of care at that time.
Tara Corey, a nurse on the maternity ward at Leominster, walked out of her last overnight shift on the maternity ward on Friday morning, taking tearful pictures with colleagues. But for now, sadness has been replaced with anger.
“We fought a hard fight. I’m proud of everything that happened,” Corey said. “But it’s just so infuriating. No matter what we do, no one has control over this situation except the hospital, and they had their minds made up before they announced it.”
Corey said she would work for the rest of her career to change the laws around how the state oversees and regulates hospital closures. Community activists too said they will turn their attention to legislation, with Romero hopeful they could at least stop such closures in other communities.
Activists also hope to regroup, and bring organizations that are willing to provide birthing services into the city.
“UMass may not want to provide it. At this point there’s nothing we can do to stop them,” Romero said. “But we can have conversations about alternatives and other options ... where transportation is not such a barrier and women aren’t having to show up in the emergency department giving birth with staff who aren’t trained to handle certain emergency situations.”
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Jessica Bartlett can be reached at jessica.bartlett@globe.com. Follow her @ByJessBartlett.