Save Burdett Birth Center Coalition’s Response to St.

Peter’s Health
Partners Plan to Close the Burdett Birth Center at Samaritan Hospital

Executive Summary – The proposed closure plan for the Burdett Birth Center is like a house of
cards that can topple over at any moment from the slightest disturbance in the air. This is not a
serious long-term plan for ensuring safe, timely, patient-centered and culturally-competent care
for the 800 to 900 pregnant people a year who rely on the Burdett Birth Center. Among the
many problems we have identified with this plan, these are the most serious:

● There is no demonstrated capacity to accommodate another 800 births at St.

Peter’s Hospital, where the already overcrowded labor and delivery unit is partially
shuttered for a “beautification” project that will not be completed until October of
2024. Even at the conclusion of the project, there will only be one more labor and
delivery room and three additional “multi-use rooms.” Midwives, doulas and patients are
reporting overcrowding and chaos at the St. Peter’s labor and delivery unit already,
without the additional Burdett patients. An account by a local midwife of chaotic
conditions at the St. Peter’s L and D is appended to this document.
● There is no confirmed and fail-safe plan for providing transportation to St. Peter’s
Hospital in Albany from Rensselaer County, especially the far-flung rural areas, or
from rural areas in Washington and Columbia counties. The plan reports that SPHP
representatives are “exploring” transportation options.
● The plan suggests that patients who are worried about traveling to St. Peter’s
Hospital at the time of delivery could consider having a scheduled induction of
labor. It is unconscionable to suggest that patients have an otherwise unnecessary
induction, which can lead to a cascading series of interventions including a c-section, in
order to allay fears caused by SPHP’s plan to shut the only maternity service in
Rensselaer County. This suggestion is non-evidence based care.
● The plan proposes housing high-risk patients at Ronald McDonald House so they
could be near St. Peter’s Hospital at the time of delivery, an arrangement that has
not been confirmed by officials of that facility and appears unrealistic. Contacted,
the new CEO of Ronald McDonald House said she was unaware of this plan and noted
that the facility prioritizes housing the families of children who are in the hospital, not
high-risk pregnant patients. How long would high-risk pregnant patients need to stay at
Ronald McDonald House to avoid having an emergency run to St. Peter’s from far out in
Rensselaer County? Would it be safe health-wise to house a high-risk pregnant patient
in a congregate living setting?
● The plan attempts to compensate for the expressed lack of trust in St. Peter’s
Hospital among Black and Brown pregnant patients by claiming that the hospital
has “a close working relationship with BirthNet, a birth justice organization in
Albany, NY.” Birthnet, however, reports that this “relationship” consisted of a
now-concluded three-month pilot project to attempt to introduce more doulas at St.
Peter’s Hospital. BirthNet has publicly opposed the plan to close the Burdett Birth
Center, and describes the closure plan’s mention of BirthNet as “misleading and
disingenuous.”
 ● The Plan includes a list of “alternative birthing centers,” suggesting that pregnant
people have a lot of other choices besides Burdett Birth Center, but these are all
traditional hospital labor and delivery units, not the low intervention midwifery
collaborative model present at Burdett. Moreover, the plan lists “Optional Ob/Midwife
Locations” including Local Care Midwifery in Troy, whose owner states in a letter to the
Health Commissioner (see appendix) “My practice is very small: I attend 30-40 births
per year. My practice is thriving: almost every month is booked. I simply am not able to
take on even a tiny percentage of the 800-1,000 births that have occurred at BCC in
recent years.” Another local midwife, Heidi Ricks of HeartSpace Midwifery, also protests
the mention of their practice in this section, explaining she is a “solo midwife practicing in
the home setting only” and stating “I am in no way prepared to fill the gaping hole is
being left by the closure of this stellar facility (Burdett.”

The Save Burdett Birth Coalition urges the New York State Department of Health to carefully
scrutinize SPHP’s inadequate and unsafe plan for closing the Burdett Birth Center and quickly
tell SPHP that the plan is disapproved. We are alarmed at comments in the closure plan and
plan transmittal letter indicating that SPHP cannot guarantee adequate staffing at the Burdett
Birth Center beyond January of 2024. Continuing attempts to undermine Burdett and cause it to
close are not acceptable and should not be tolerated by the Department of Health.

Capacity Issues at St. Peter’s Hospital

There is not sufficient capacity at St. Peter's labor and delivery unit for the current patient load,
according to multiple reports from former employees as well as local doulas and birth workers
familiar with the hospital. The SPHP closure plan states that after renovations are finished in
late 2024, there will be one extra labor and delivery room to absorb an additional 800-900
patients. Administrators have also outlined in the closure plan that three postpartum rooms can
transform into low-risk midwife intrapartum rooms if the labor and delivery unit is at capacity.
What if the postpartum unit is also at capacity and those three rooms aren’t available? In
November 2023, a high-risk patient was in a postpartum room during labor due to crowding on
the labor and delivery unit when her electronic fetal heart monitoring indicated fetal distress. The
patient was delayed in getting to the operating room because of the distance they had to travel-
past a full waiting room of strangers while in active labor. Thankfully the baby and mother are
ultimately healthy, however, they were separated for several days by a NICU stay that could
very well have been prevented.

We have also heard stories of several people giving birth in the St. Peter’s Hospital PACU (Post
Anesthesia Care Unit), which is a specialized area where patients recover after surgery. This is
unacceptable as there is very little room in this area for all the necessary birth attendants and
only a curtain separating one bed from another. Even births in the triage rooms are
unacceptable, and yet they happened several times in 2023. There is no space in these rooms
for the birthing person to move freely to help and cope with labor, nor is there room for support
people. They share a small bathroom with the person in the next triage room. In these
scenarios, patient privacy is impossible to maintain and the providers and nurses are forced to
work in inadequate spaces. This chaos undermines patient safety in myriad ways and risks the
professional licensure of staff, because this is the type of situation in which mistakes or
miscommunication can happen. Ultimately, overcapacity leads to safety concerns for patients
and staff.

In addition, we are aware that over the past two years, St. Peter’s has diverted Capital Region
Midwifery patients to give birth at Bellevue Woman’s Center in Niskayuna, a facility that was
previously unknown to the patients, without their providers. One such patient had sought out
midwifery care, spent her entire pregnancy getting care from the midwives and then had to give
birth in a hospital that did not have the tools she had planned to use for pain management
available to her, and was attended by a physician that she had never met. If overflow is
happening already, regardless of risk factors, before Samaritan OB/GYN and Capital Region
Midwifery bring their patients to St. Peter’s for delivery, how will the situation be once all
deliveries are at St. Peter’s?

Lastly, there have been midwife patients who were in triage at St. Peter’s because Burdett Birth
Center had re-routed them due to staffing and then when staffing was resolved those patients
then came to Burdett Birth Center. The patients then complained about their care at St. Peter’s
stating “I wasn’t allowed to eat despite being in early labor and not yet admitted to the unit” and
“I was planning on a natural birth and while waiting in triage I didn’t have enough room to walk
or even use the birth ball and was stuck in the bed which is not at all how I wanted to cope with
the pain of labor.” The midwifery model of care is a specialty service that is not available at any
other local hospital in the Capital Region, and it is naive, if not misleading, for hospital
administrators to propose that this excellent and successful model of care can be seamlessly
transferred to a different facility that has a more traditional medicalized model of labor and
delivery. In addition to patient safety concerns, patient satisfaction will be greatly reduced with
overcrowding.

Problems with the transportation “plan”

In its closure plan, SPHP doesn’t provide any meaningful or tangible solutions regarding the
serious issue of transportation to St. Peter’s Hospital from Rensselaer County and rural areas in
adjacent counties. The Community-Led Health Equity Impact Assessment issued by our
coalition in September found serious transportation issues that have a direct impact on the
medically underserved in Rensselaer and surrounding service areas. We found, for example,
that there are no buses that run from Troy to Albany in the middle of the night, there are limited
routes in Troy and there are little to no bus routes in most of the county at any time of day. We
also know that 22% of Troy households do not even have a car.

The closure plan tries to minimize the transportation challenges that would be created by the
closure of Burdett by stating that “what may have been a 5-minute or 10-minute drive to
Samaritan Hospital may become a drive of more than 20 minutes to St. Peter’s Hospital or an
alternate facility.” That may be the case for people who live in Troy near the Burdett Birth Center
and have a car, but travel to St. Peter’s from rural areas of Rensselaer, Columbia, Greene and
Washington counties would be far longer, according to analysis from the March of Dimes. March
of Dimes experts calculated a 300% increase in travel times overall for affected pregnant
people, should Burdett close, including travel times of 45 minutes or more from Columbia,
Greene and Washington counties to St. Peter’s Hospital.

SPHP officials state that they are “holding discussions,” with rideshare services such as
Ambulanz, Roundtrip and Tech Valley about potential contracts for patient transportation. Upon
investigation, we’ve learned that these apps and services are third party contractors who work
as the middleman between rideshare services and hospitals. These services are not reliable for
the medically underserved people who need them because they don’t run often enough and are
dependent upon how many drivers are picking up rides at that particular time of day, if at all.
They do not pick up in emergency situations and they do not serve a majority of the far-flung
geographic range of Rensselaer County and adjacent counties. The closure plan description of
Tech Valley services, for example, explicitly states that Tech Valley will be a “non-emergent
patient transportation option, from planned to urgent care appointments, and is available
24/7/365 with advanced notice.” We have boldfaced the important limitations to this service.

These are not new or additional services. This is an already-existing pool of drivers and services
– the same services that an individual would use, except that some drivers within the pool have
been trained in HIPAA. How will partnerships with existing, overstretched and expensive
services address this issue? There are already a number of barriers to safe and timely obstetric
care and the fact that this option is just a possibility on the part of SPHP shows the lack of
seriousness to address transportation.

SPHP claims they will follow up with patients who indicate during their prenatal needs
assessment that they have transportation challenges, but there’s a difference between giving
referrals and having adequate services that actually address the issue. The Health Equity
Impact Statement completed by the Chartis Group indicated that SPHP would explore the
option of hiring a Transportation Coordinator. But this position is not mentioned in the closure
plan. Who will provide these referrals and how will they ensure transportation is arranged?
Considering the ongoing shortages in staffing for case management and social work, there is a
great deal of concern that high needs and high risk patients will not receive the appropriate
referral, let alone gain access to transportation services.

The existing Troy EMS system is short staffed and operating with only four ambulances. The
strain of transporting more people from Troy and rural areas of Rensselaer County to St. Peter’s
Hospital or Albany Medical Center will put everyone in need of EMS services at risk. Troy EMS
testified they are already overwhelmed.

We have been told that Mohawk Ambulance would fill the gap, but have heard no evidence of
how that would be possible if Mohawk Ambulance Services is not given additional support.
Additionally, we have been told that Mohawk Ambulance routinely requires mutual aid from
other fire stations, which is a clear indication that they are already overstretched and
under-resourced. Mohawk Ambulance is not a solution because like the “plan” to use Uber/Lyft,
it does not add services, it is just an existing service that’s being asked to do more.
In recent weeks, the Troy Fire Department’s EMS service has continued to experience
dangerous levels of short staffing at Samaritan Hospital. They have said they continue to wait
with patients in the hallway of the ER for as long as three hours before a bed opens. If their
firefighters are tied up with patients waiting for ER beds, they are at risk of not being able to
return to the rigs to get them back online if and when a fire call comes in. While SPHP claims
that pregnant patients will be rushed upstairs while Burdett is still open or to St. Peter’s if
Burdett is on diversion, there remain serious issues regarding capacity and safe staffing and this
is all happening while Burdett is still open. How would this closure improve safe staffing and how
could this closure possibly make maternal health care more accessible when the various
barriers like transportation remain and the care consolidates into one overcrowded labor and
delivery unit at St. Peter’s?

Unconscionable transportation solution: Have an unnecessary induction

Perhaps the most shocking part of SPHP’s closure plan for Burdett is found on page 16: The
expectant mother can speak with her SAM OB provider about a planned induction of labor if the
patient is concerned about the distance to SPH. Inductions can lead to a cascade of
unnecessary medical interventions in the birth process, including c-sections. St. Peter’s Hospital
already has a far higher rate of c-sections (36%) than the Burdett Birth Center (24% overall, and
only 16% for midwifery clients). Suggesting planned inductions to solve a transportation problem
that SPHP is creating runs counter to New York’s Department of Health’s quality improvement
program to reduce the rates of unnecessary c-sections. Moreover, it would never be a best
practice for care to medically-underserved patients to electively induce labor without a medical
indication.

Potential use of Ronald McDonald House to house high-risk patients before birth
A member of the Save Burdett Birth Coalition contacted the new RMHC CEO Kimmy Venter on
January 8, 2024 and found she was not aware that the facility was cited in the SPHP’s closure
plan for Burdett as a place where high-risk pregnant patients could be housed before birth, if
their homes are located some distance away. The Ronald McDonald House’s general rule is
that they serve families who live 40 miles or 30 minutes from the hospital - and their priority is to
house families with a child in the hospital. They have 25 rooms and are usually at 60 - 70%
capacity but that number often fluctuates. They would prioritize a family with a child in the
hospital over a pregnant patient, however if they had the capacity they would absolutely serve
the pregnant patient.

She said RMHC has not traditionally housed a lot of families of children undergoing treatment at
St. Peter’s as most families require more critical care at Albany Medical Center. She noted that
Albany Med provides a 24 hour shuttle to families residing at Ronald McDonald House, but St.
Peter’s does not/has not done the same. Whoever might be setting up that transportation is
currently unknown.

BirthNet’s Response to SPHP’s claim of a “close working relationship” with BirthNet

In the closure plan, SPHP states that “Health equity is a cornerstone of our mission.” The plan
then goes on to claim a “close working relationship” with BirthNet. The Save Burdett Birth
Coalition asked BirthNet for a response to this statement, given that we knew BirthNet was on
record opposing the plan to close the Burdett Birth Center. Here is their response:

“BirthNet is an Albany-based, non-profit, Birth Justice organization whose mission it is to

eliminate the inequities in birth outcomes for all people and to ensure that all birthing families
receive respectful and supportive maternity and infant care. We are referenced in the SPHP’s
Burdett Birth Center closure application as a community partner, and we want to report that our
mention in this closure application is both misleading and disingenuous. We would like to clarify
our relationship with St. Peter’s Hospital.

BirthNet was awarded a HANYS grant for $20,000 in 2023 to conduct a very small Doula Pilot
Project in collaboration with St. Peter’s Hospital’s Labor and Delivery unit. The focus of the
project was to provide doulas on the unit during a three-month period from September to
November 2023. Given our limited resources and available doulas, we provided only eleven
(12hr) shifts during the time frame from September 5th through November 8th, 2023. Our grant
period ended, and we are no longer affiliated with St. Peter’s Hospital in any way.

We had many challenges in partnering with St. Peter’s Hospital, some of which had to do with
transparency and expectations, suboptimal treatment of our Black and Brown doulas, and the
lack of clear or concise communication. The BBC closure application mentions that doulas are
available to patients to attend surgical births, which our doulas were denied, creating a complete
lack of support for the birthing woman at their most vulnerable time in labor. Nor were our
doulas allowed back in the recovery area after surgical births, creating several hours of simply
waiting for the client to be returned to the room. Again, this created a disconnect of access
between the doula and her client for critical skin to skin care and breastfeeding support in their
most vulnerable hours. Our doulas were underutilized during the limited shifts, nurses were
often unaware that they were there, and the doulas were largely unable to provide the broad
range of services that doulas are trained to provide.

BirthNet, like many other community organizations, was outraged by what SPHP referred to as
their “Town Hall” meeting on November 9th. There was no opportunity for real discussion, and it
was completely controlled by the hospital representatives. It was clear that this Town Hall was
an opportunity for SPHP to simply check a box that they had community input, when in fact it
was a shocking misrepresentation of any kind of real and meaningful community engagement.

Finally, we want the NYSDOH to know that BirthNet is vehemently opposed to the proposed
closure of the Burdett Birth Center. Closing Burdett runs completely counter and is in direct
opposition to our mission and our vision. Burdett cares for marginalized birthing people and
BIPOC birthing families better than any other labor and delivery unit in the entire Capital Region.
At Burdett Birth Center, Black and Brown birthing women have exceptionally good outcomes,
feel tremendous satisfaction with their birth experience, have far fewer surgical births which
reduces the unconscionable high rate of maternal mortality and morbidity and have greater
success with breastfeeding. All of which makes for healthier women, healthier families, and
healthier communities.

Please reach out to the Board Members listed below if you have any questions or need any
clarification about our being aligned with SPHP in their closure application.”

With hopeful regards,

Esther Patterson, Co-Chair, Board Member (518) 331-9890

Tisha Graham, Co-founder, Board Member (518) 366-2159

Appendix A – Story of a chaotic birth experience at St. Peter’s Hospital in December 2023

Birth Story of concern from Betsy Mercogliano, CNM/LM, CD, RN

My client having baby #2, VBAC, lives in Saratoga, driving to StPH Ob/Gyn practice in Albany
for all appts as VBAC option not available at Saratoga Hospital. EDD December 4, 2023.
Planned induction of labor at approx. 39 weeks. The major points here are – no communication,
overbooked status, no provider oversight including no exam prior to start of Pitocin drip when
first Foley fell out, no provider assessment for over 12 hours, overbooked status when late
decels diagnosed, no lactation or provider visit in pp for first 24+ hours. Please note: as an
experienced provider myself, I want to underscore that this report is NOT a reflection of poor
nursing care or even poor provider care. This report is a glaring look at a systemic problem of
SPH labor and delivery unit being over-booked and chaotic, putting care providers in an
impossible position of being unable to give safe, good care to the number of people on the unit.
These problems come from decisions made by managers, not direct-care staff.

Quick synopsis:

1. Family given induction date of 11/27/23, Monday eve at 6 pm as start date to arrive at
hospital for monitoring and Foley balloon placement. Given the one hour drive to hospital and
child at home, they called StPH labor and delivery unit directly at 4:30 pm to confirm that there
was still space/staffing etc for them to plan on 6 pm arrival. Were told yes, come ahead.

2. Family were 20 min late, called unit to alert, again told, come ahead.

3. Arrived with doula (me) at entrance door of L & D at 6:25Pm. Without entering, were told to
go directly to postpartum floor to report in.

4. At pp floor, were shown to a room by RN.

5. 8pm – having seen no one, no staff, no providers for this hour and a half, husband and
doula went out to front desk of pp to inquire what was the plan. Were told that “L & D was really
slammed and it would be many hours before the induction could be begun”. When asked if the
Foley could be placed on this unit, was informed that was not possible because monitoring had
to happen. Nurse was apologetic but did not have any clear sense of any timeline.

6. As doula, I went to L&D to inquire. Was told they had 18 people in labor and there would
be no possibility of starting the induction “for many hours”. When asked for more clarity, was
told, “4 clients might give birth in the next 4 hours and then there may be room”. I asked the
receptionist why family was not informed of this backlog when they called. This receptionist said
she came on shift at 7pm, so was not the one who answered the call, but said, “I can’t imagine it
wasn’t already slammed at 4 or 5”.

7. Family ordered food, doula went home to await call.

8. Foley finally placed at 5 am on 11/28/23, Tues morn. And filled with sterile water to 4cm.

9. RN gave Foley “tug” at about 10:30 am on 11/28/23 and it fell out. NO exam done, Pitocin
drip started at low dose to induce contx. Doula present intermittently as family rested and
adjusted.

10. No providers came in room all day except for RN to increase the Pitocin at appropriate
intervals. Mild contractions and rest most of the day.

11. Approximately 5 pm, triage MW arrived, performed vaginal exam and told family that “Foley
had not been placed in the cervix at all and the cervix was a fingertip dilated.” They would need
to start all over. After family had dinner, washed up etc, Foley replaced correctly in evening of
11/28/23 around 10pm, family to sleep, doula home.

12. Foley fell out around 5 am 11/29/23 examined to be 4-5 cm, -1, not fully effaced, contx
being felt, doula called.

13. Family rested, moved, tried many different positions with doula support, got epidural late
morning when contx got stronger (her plan). Pit was up to 5, family concerned before epidural
at “intensity of contx”, found out the RN had increased the pit without informing family per their
request.

14. About 1 pm 11/29/23, late decels noted. Dr. Surmelli in, suggested repeat c-sec as no
change in cervix (still 4-5, baby high) and concern for baby with late decels. Doula (me) arrived
to switch with other doula. Family sad but understanding baby needed this help. Dr. S
advocated for doula to go into OR and PACU, but was denied by “nurse manager”. Waited, with
continued late decels with almost every contx (pit off, contrx continued at q2-4 min, long and
strong) for almost an hour to go to OR. RN was helpfully pushy and concerned as she kept
working to get the family moved to OR. Stated that it was chaos on the floor. When family went
to OR, Doula went home to return when family was in pp.

15. Surgery went well, baby healthy, mom and dad over the moon with their baby girl. I saw
them in pp for short visit, all looked well. Mom had had significant tongue-tie challenges with
first child’s breastfeeding relationship, so had already asked that IBCLC visit as soon as
available.

16. 11/30/23 – doula visited late afternoon – family well. Family reported no lactation support,
no provider visits at all all day.

17. Family returned home 12/1/23. Healthy but disturbed by erratic care.

Appendix B – Letters to state Health Commissioner from local midwives

January 9, 2024

James V. McDonald, M.D,

M.P.H. NYS Department of
Health Corning Tower,
Empire State Plaza
Albany, NY 12237

Dear Commissioner McDonald,

As a NYS Licensed Midwife, Small Business Owner, and a Resident of

Rensselaer County, I am very concerned about the proposed closure of
Samaritan Hospital’s Labor and Delivery Unit (aka Burdett Birth Center). While I
have many thoughts on the matter that I am happy to speak with or your staff
about, I will limit this letter to the following: the term birth center and listings in
Appendix C of St Peter’s Health Partners letter to you dated December 21, 2023.

The term ‘birth center’ is generally used to mean a free standing childbearing
center such as members of AABC (https://www.birthcenters.org/what-is-a-bc).
Since the term Birth Center is not trade-marked, it is sometimes used by
hospital labor and delivery units (such as Burdett Birth Center) for marketing
purposes. As a successful small business owner, I have an understanding of
marketing. However, for SPHP to list in Appendix C every hospital labor and
delivery unit within 46 miles of BBC as ‘Alternative Birthing Centers’ seems
 disingenuous. These are all Birth Facilities, Hospital Labor and Delivery Units.
They are not ‘Alternative Birthing Centers’.

Appendix C also lists ‘Optional Outpatient OB/Midwifery Locations’. According to

this list, the only ‘Optional’ providers with Troy addresses are myself (Local Care
Midwifery, PLLC) and HeartSpace Midwifery. My practice is very small: I attend
30-40 births per year. My practice is thriving: almost every month is booked. I
simply am not able to take on even a tiny percentage of the 800-1,000 births that
have occurred at BCC in recent

years. HeartSpace Midwifery 1) no longer has a Troy office and 2) like myself is
unable to flex upward to accommodate more clients should BCC close.

Having been a midwife in Troy for the last 25 years, having worked both at
Samaritan Hospital and at St Mary’s for 10 years before started my own practice
in 2009, I have many concerns for the health of my beloved community. This
proposed closure is high on that list. As stated above, I am happy to discuss
this issue further with you or your staff. I can be reached on my cell at 518
322-1992 or my personal email, kmdoyle@me.com.

Sincerely

K. Michelle Doyle, MSN, BCST, CNM, NYS LM, FACNM

January 7, 2024

To Whom It May Concern:

I am writing regarding the proposed closure of Burdett Birth Center in Troy, NY. It has been
brought to my attention that this practice is listed as a potential site for people to seek care
if/when BBC closes. This is nothing short of insane! This is a micro practice with a solo
midwife practicing in the home setting only. Home birth has been growing in the Capital
District for decades and I am as busy as I can possibly be with my repeat clients and the
occasional new family. BBC serves a very different population than the home birth midwives
serve. Many BBC patients have factors that would immediately risk them out of care with this
practice. I ask to be removed from any publication referring to this site as an alternative to
Burdett Birth Center. I am in no way prepared to fill the gaping hole that is being left by the
closure of this stellar facility.

The closure of BBC is going to encourage the skyrocketing rate of “Freebirthing” in this area.
If you don’t know what this refers to please do some research online where you will find that
many families are frustrated/angry with the care they have received in the typical medical
setting, cannot or will not pay for the services of a licensed provider to assist in an
out-of-hospital setting, and are going it alone. BBC has been the antidote to this trend. I am
confident that this closure is going to push people to make the choice of unassisted birth out
of necessity or fear of the alternatives to the midwifery model they have come to know and
respect at BBC. These families will be at risk for serious complications at home. The
morbidity and mortality that is sure to arise from this will and should be laid at the feet of
those who are making the decision to eliminate the best option for many birthing families in
the Capital District.

I have written before to express my dismay at the decision to close BBC from the perspective
of this practice. This decision affects not only those seeking a midwifery-led team in a hospital
setting but also those choosing to birth in the community setting. This practice has depended
on the providers and the facility in Troy when a hospital transfer of care is necessary in labor.
I have had collaborative relationships with many providers at BBC over the years. BBC has
always been the most respectful place to transfer to when complications arise risking birthing
families out of the home setting. St. Peter’s Hospital has traditionally been less than
respectful to the point of denying to accept transfers of both birthing people who planned to
deliver with a licensed provider at home and babies who need additional care after birth. This
is a pattern that I see only becoming worse with the added stress of absorbing yet more
families into a facility that is obviously already stressed and unsupportive of those making the
choice to birth in the community setting.
 I have read the letter to the NYS Department of Health dated 12/21/2023 in which all the
justifications for closing the Burdett Birth Center have been laid out and the plan for those it
will affect is shared. It is well written and, on the surface, looks great. The havoc this is
wreaking in the birthing community is in no way expressed in this tidy package. The birthing
families and birth workers are the ones with boots on the ground. They know the alternatives,
which is why the midwifery-led birth center was created.

Unfortunately, the criminal nature of this decision will not be made evident until the morbidity
and mortality rates climb once again in Capital District due to lack of access to the care the
supporters of BBC have come to respect.

In closing, let it be known that the home birth community is as unhappy with this decision as
those who choose to birth at BBC. And once again, I ask that HeartSpace Midwifery, PLLC be
removed from your list of alternatives to BBC.

Sincerely,

Heidi Ricks, LM