Fight to Save a New York Birth Center Tests State Law

Pink “Save Burdett Birth Center" signs started popping up throughout Troy, a city of around 50,000 people about 8 miles north of Albany. The New York law, which requires state officials to consider the potential impact of proposed health-facility changes on underserved people before granting approval, galvanized efforts to halt the planned closure.

As waves of maternity-ward closures hit communities across the U.S., driven by declining births, staffing shortages and shrinking revenues, local patients and advocates have been fighting to save birthing units. Now, some states are stepping up efforts to preserve such services.

Several states have tightened oversight of healthcare in recent years. After months of public outcry, Connecticut health officials last month denied a plan by Nuvance Health to close the maternity unit in Sharon, Conn. Last year, Oregon launched a Health Care Market Oversight program, which allows health officials to review business deals involving hospitals, health-insurance companies and provider groups to promote transparency and improve health equity.

In New York, the planned shutting down of the Troy birth center will be a test of how state officials make use of the new law.

“This is the most ambitious attempt by any state in the nation to insist that the likely impact on medically-underserved people be an important consideration," said Lois Uttley, founder of Community Voices for Health System Accountability, who helped to push the legislation.

After the planned closure was announced, advocates organized rallies, forums and conducted their own community impact survey. Earlier this month, dozens of residents testified during a five-hour public hearing hosted by New York Attorney General Letitia James, whose office regulates nonprofits.

The Burdett center, which delivers roughly 900 babies a year, was created in 2010 as part of an agreement to form St. Peter’s Health Partners, a not-for-profit healthcare organization based in Albany that is now part of Trinity Health, a Catholic healthcare system based in Livonia, Mich. Troy previously had three independent hospitals, but now Samaritan has the only maternity center in the city.

St. Peter’s filed an application on June 20 with the state Department of Health to close the Burdett unit. St. Peter’s cited financial difficulties due to declining births and “unfavorable payor mix," among other factors that led it to seek the closure.

A little over half of the patients at the center received Medicaid, which reimburses providers at lower rates than private insurance, health department data showed. The center had a loss of $2.3 million last year, according to St. Peter’s.

Advocates say the center benefits patients because it is accessible, lower-cost and its midwifery model is less intimidating for many people. Christina Eaton, who lives 5 minutes away from a maternity unit in Albany, said she chose Burdett instead because of its midwifery-led model.

Albany has two birthing units and is a 15- to 45-minute drive from Troy, but nearly a quarter of Troy residents don’t have a car, U.S. Census Bureau data showed.

One of the issues that came up in the September hearing was whether St. Peter’s gave adequate notice. Following criticism from lawmakers and advocates that it was trying to evade the law, St. Peter’s said it would voluntarily conduct a community impact study. The results of that study haven’t been made public.

In a statement, the New York State Department of Health said that neither the impact study nor the required closure plan have been submitted by St. Peter’s. The department can’t make a decision on the closure until it has received and reviewed those materials, and “this process will take time and is not imminent," according to the statement. The department said it would have no comment on the process until it receives and reviews the study and closure plan.

In written testimony submitted to James, Steven Hanks, president and chief executive of Trinity Health New York, said its leadership and the board stood by their decision, reiterating reasons such as declining births and staffing shortages.

A St. Peter’s spokesperson said that births at the unit have dropped from 1,883 in 2013 to 881 in 2022 and high turnover has made staffing very difficult. Prenatal and postnatal care will still be provided in Troy, and patients can still have midwife deliveries at St. Peter’s Hospital in Albany, the spokesperson said.

Michelle Doyle, a veteran midwife who has delivered more than 1,300 babies in the Troy area, said the closure would affect not only Rensselaer County, in which Troy sits, but would leave a stretch of eastern New York from Essex County to Columbia County with no labor and delivery unit.

“People really want healthcare here," Doyle said.

Ashley Saupp, co-organizer of Save Burdett Birth Center Coalition in Troy, said the center’s services are needed in Troy. “As a white woman who lives in a comfortable setting, my concern really is about the safe birth outcomes for those who don’t have what I have," she said.

Jayana LaFountaine, a doula with clients at the center, said she believed the county’s maternal and infant mortality rates would rise without Burdett. The maternal mortality rate was 21.0 deaths per 100,000 live births in Rensselaer County, compared with 19.3 in New York state, according to estimates by the state health department.

Nearly one in four residents in Troy live in poverty, compared with 14% in New York state, Census Bureau data showed. The city’s median household income was 67% of the statewide figure, according to estimates from the bureau.

Starletta Washington, executive director of YWCA of the Greater Capital Region and a Troy native, said the future for the city is bleak without the birth center.

Almost all the women staying at the YWCA facility in Troy who gave birth at Burdett relied on Medicaid, Washington said. “People already say downtown Troy is a food desert," she said. “Is Troy going to be a maternity healthcare desert?"

Write to Liyan Qi at Liyan.qi@wsj.com