Mercy Medical Center is parting ways with a midwife group that has worked out of the hospital for years because of rising malpractice insurance costs.
The decision to close Kathleen Slone CNM & Associates, which plans to stop delivering babies in February, leaves women with fewer birthing choices outside of the traditional doctor.
But Mercy said high-profile medical malpractice cases in recent months have driven up the cost of insurance, and the hospital was looking for ways to alleviate the financial pressure. Two Baltimore cases, while unrelated to Mercy, contributed to a doubling of the hospital's malpractice insurance costs in fiscal year 2013, according to bond rating company Moody's.
In one case in May 2012, Rebecca Fielding and Enso Martinez won a $55 million judgment against Johns Hopkins Hospital after their son was diagnosed with hypoxic ischemic encephalopathy, a disease that causes permanent cognitive delays.
The birth had started at home, overseen by a midwife, but the mother was rushed to Hopkins because of complications. The couple said the hospital was liable because the baby was deprived of oxygen to the brain as the mother awaited a cesarean section there.
The judgment, one of the largest ever in Maryland, was reduced to $28.3 million by a trial court and eventually thrown out and sent back to a lower court by the Maryland Court of Special Appeals. The case is still pending.
In the other case, in 2012, a jury awarded $21 million to a Glen Burnie couple whose son was born prematurely with cerebral palsy at Harbor Hospital in 2002. In the lawsuit, the family claimed the boy, Jaylan Norfleet, became oxygen-deprived while in his mother's womb and that medical providers at the hospital should have performed a cesarean rather than allow a prolonged vaginal birth.
"The worsening litigation environment in Maryland is driving up the costs of obstetrics programs and Mercy, like other Maryland health systems, is being forced to re-evaluate and adjust related services," the hospital said in a statement.
Mercy, which will continue to offer OB/GYN care, would not say specifically why it chose to end its relationship with Kathleen Slone and not other doctors.
Kathleen Slone CNM & Associates is a practice of four midwives who perform water births, natural births and other techniques not used by traditional obstetricians. The practice delivered 236 babies in 2012, all of them at Mercy.
Many of the group's patients expressed anger over Mercy's decision. By late Friday, an online petition that calls on the hospital to rescind its decision had garnered about 200 signatures on Change.org.
Expectant mother Kathy Webb of Catonsville said she came to Slone's practice months into her first pregnancy six years ago after deciding an obstetrician wasn't a good fit for her. Webb, whose second son is due in December, said she is "sad, angry and frustrated" that other women won't have the same opportunity at Mercy.
"It's such a personal thing to go through this process with someone, to bring your child into the world," Webb said Friday. "It's not just about me, it's about taking away choices for women. The medical community is so geared to telling women what to do, and they are taking another option off the table."
The group said on its website that it was saddened about having to close the practice. Midwife Caitlin LeGros said their deliveries are low-risk. She said midwife practices are sometimes viewed as "outliers because we don't practice defensive medicine, using all the efforts you can to prevent complications."
Advocates such as Debbie Pulley, director of public education and advocacy for North American Register of Midwives, defended midwifery, saying the United States is one of few countries that does not use midwives as the primary care provider for pregnant women.
"Midwives spend more time with mothers, educating them, and they have better outcomes," Pulley said. "Midwives are going to look at birth as a natural process."
Midwives offer an alternative to "overuse of interventions and high instances of cesareans," said Mary Lawlor, director of the National Association of Certified Professional Midwives.
"All pregnant women should have access to midwifery care in all settings — homes, birth centers and hospitals," Lawlor said.
The Mercy-based practice will provide full services until February and limited services, including annual exams, until its contract runs out in April, said Bayla Berkowitz, a midwife with the practice.
"I think the main issue right now is that women's choices are being reduced drastically," Berkowitz said. "For women who don't want a hospital birth, it is getting very difficult. Women should be able to choose who they want to attend their births, where they want to give birth and how they want their birth to go."