Birthing center consolidation hits Upper Valley

There's a big change coming to birthing centers in the region, most notably in the Upper Valley. Alice Peck Day Memorial Hospital will soon no longer be delivering babies, leaving Dartmouth-Hitchcock Medical Center as the primary provider.

March 12th, 2018, Sofie and Matt Smith were given the gift of life. "It's wonderful, it's beautiful, it's overwhelming. I can't believe she is ours," Sofie Smith said.

Little Nora Elise came into this world a couple of weeks early. The Smiths were planning on delivering their first child at Alice Peck Day Memorial Hospital. "We heard great things about it. Just, also because it is smaller scale. We decided we wanted to go there," Sofie said.

But high blood pressure in Sofie's third trimester meant she was at high risk for complications, so they were transferred to Dartmouth-Hitchcock Medical Center. "We were a little nervous about it," Matt Smith said.

The couple had been working with a midwife and were passionate about the intimacy of a smaller facility like Alice Peck Day. But to their pleasant surprise, DHMC delivered in more than one way. "I said that I wanted to be involved in the whole process and they let me be right there by Sofie's side the entire time. They allowed me to help grab the baby as Sofie gave birth," Matt said.

"We couldn't have asked for better support," Sofie added.

Nora's birth comes as the industry undergoes changes. Both APD and the Lakes Region General Hospital in Laconia recently announced that they would be ending birthing services later this year. Doctors say there are three major factors -- The difficulty of recruiting and retaining providers, the current reimbursement structure for deliveries, and the high fixed costs associated with birthing centers.

Alice Peck Day will continue to provide prenatal and postnatal care, but moving forward, delivery services are being integrated at Dartmouth-Hitchcock. "It is really really important to us that we maintain that model of care. And that we strengthen that model of care," said Dr. Tim Fisher, a DHMC obstetrician at DHMC.

And that model of care includes a strong relationship with midwives. Fisher recently published a study that essentially created a score card for midwifery services and healthy outcomes for babies. He says Maine, New Hampshire and Vermont all scored very well. "What we found is a really strong association at least, of places where midwifery is highly integrated and places where there are high quality outcomes for mothers and babies," he said.

That's something Sofie and Matt Smith can attest to. Though, having a happy healthy little girl helps. "So many different wonderful things at once," Sofie said.

Consolidation plans are already underway, which includes additional renovations at DHMC. Births will continue at Alice Peck Day Memorial Hospital until this summer.