Date: 1 Nov 1996
Subject: Unwarranted Suspension of Hospital privilages for
Certified Nurse Midwife Beah Haber after 10 years of exemplary practice
As most of you know, I received hospital privileges at Valley Care Center ten years ago. Almost four years ago, I joined Dr. Bleecker's practice. My love and passion for homebirth was joined with a hope of making a difference in the hospital setting. Through the years, Dr. Bleecker and I were able to make a lot of changes at Valley. Jacuzzis were included in the birthing rooms. Our clients did not receive routine IVs or monitoring. The nurses became our friends, curious about our difference in philosophy and eager to care for our moms and babies. This did not happen smoothly, along the way we met various degrees of harassments, but we seemed to make our way through it.
About a month ago I received a letter telling me that because of "several complaints" (which all seemed to stem from the same pediatrician), and the management of a certain case (where they didn't agree with my taking off the monitor from a high risk mom to allow her to walk), they had decided that ALL of my clients would HAVE to be continuously monitored. They also instituted a 2 year retrospective chart review.
Thirty-one charts were reviewed by a team of four OBs. They found problems with 30 of them. The problems were generalized as: 1) Inadequate documentation, 2) working outside of the standards of practice for a CNM, and 3) working outside of protocols. I was told that I had 14 days to answer the charges. Dr. Bleecker and I reviewed the charts and were flabbergasted. We couldn't understand the basis for these charges. For example, I was charged with delivering twins without consultation while the chart clearly showed Dr. Bleecker had been present throughout the delivery. Another charge was that I had induced a high risk mom without consultation. Yet, the chart clearly noted that Dr. Bleecker had called the orders in and had actually come in himself to see the clients. The more we reviewed the charts, the more it seemed to us that this was an all out witch hunt.
The effects of these actions seemed to quickly spread and involved everyone in Labor and Delivery. The OBs we thought would be supportive withdrew their support because of unnamed "pressure" within the OB Department. One nurse was fired without previous warning, for being supportive of my practice. Other nurses are afraid to speak up for fear of losing their jobs. The unit's morale is low.
To make a long story short, I was suspended before my allotted time to respond to the charges made by the chart review committee. I had no opportunity to defend myself. It seemed as if they weren't even interested in my response. I went to see a lawyer who said, "This may be unethical, illegal and unfair but you don't have the money to take on the hospital."
I went to the first appeal with the Executive Chief Committee. It lasted 20 minutes. I wasn't allowed to bring anyone with me. They read the charges: 1) persistent and pervasive problems with documentation, 2) consistently working outside of the standards of practice for CNMs, 3) violating protocols and 4) consistent errors in judgement. I was asked if I had anything to say. I told them that both Dr. Bleecker and I had reviewed the charts and we couldn't find ONE case that supported the charge of violating protocols, standards of practice or of using poor judgement. There were few questions or comments and I was excused. Two weeks later, I received a letter, obviously written by their attorney, informing me that the suspension would still remain in place to protect the safety of the patients at Valley Care Center.
Meanwhile, many of my clients were upset that I wouldn't be able to attend their births as their midwife. I decided I would go with Dr. Bleecker and offer moral support as a childbirth assistant. After attending one delivery, the hospital sent me a letter stating that I had violated my suspension ... Essentially, I had been banned from the hospital.
This has been quite an experience. Dr. Bleecker described it perfectly when he said, "I watched a woman get raped and they want me to pretend it didn't happen." First, the process brought me through self-doubt, and then, extreme anger at the system. The system lacks character, honesty and justice.
The next and LAST appeal available to me is a formal hearing. I was told by one lawyer that it would cost about $10.000. I have to go through the formal hearing if I want to even consider bringing a suit to the Supreme Court against the hospital for anti-trust and defamation fo character (another $10,000 to $20,000). If I don't fight my suspension, I may never be able to get priviliges at another hospital. Part of me doesn't care, I DON'T want to play dirty games and politics. I became a midwife because I believe in women and families birthing babies their own way, not being pushed into a mold that only serves to protect the provider from lawsuits. But, to leave Valley Care Center and walk away doesn't just hurt my reputation. It hurts women, babies and their families. It hurts midwifery in the valley and in the country.
To allow an uncaring system to decide whose loving words you'll hear when you walk through birth is to allow defeat. We have worked hard to get where we are. Midwifery must remain an option. Women choose midwifery because they don't want to be treated like reproductive machines. Modern obstetrics, monitors and routine interventions can rob us and complicate a time of intimacy and personal power.
I will keep fighting. I will speak for the women who cannot find their voice to scream for the right to birth their babies in their own way. However, I cannot do it alone. I need the help of all of you who feel called and refuse to be silenced by the system.
Foremost, I need your emotional support. If you have the time or energy to help us organize, please call the names below. We need financial contributions. The formal appeals deadline is November 3, 1996. If you have any great ideas for raising money we would love to hear from you. Also, we are looking for an attorney who will take this case on a contingency basis.
The one positive thing that has come out of this ordeal is that I will be able to focus on the homebirth practice. I will have more time to be with women and their families and this is an answer to the wishes of my soul. Also, Barbara Leon is finished with nursing school. We are joining together to rebuild the homebirth practice. We both believe that a homebirth helps to support women as they walk through one of the most transforming and powerful times of their lives.
Love to you all,
P.S. If you know of anyone that you think might be able to help -- please tell my story.
[All contacts are in the East Bay area near San Francisco, U.S.]
Lisa Terri - 510/846-9334
Linsley Rollins -510/426-7017
Patty Drury - 510/426-2300
Barbara Leon - 510/443-0532