In late 2023, state officials approved the closure of Windham Hospital’s labor and delivery unit, on certain conditions. Among them: Hartford HealthCare, the hospital’s owner, had to study the feasibility of opening a freestanding birth center in the region.
That study is now complete. And in a meeting with members of the community earlier this week, Guidehouse, the independent consultancy that conducted the report, presented its findings.
Opening a birth center is not feasible, the consultants concluded.
“Based on the findings from the variety of assessments and analytics,” the report reads, “Guidehouse believes a [freestanding birth center] is not feasible to establish and provide safe and high-quality care for women” in Windham Hospital’s service area.
The Guidehouse consultants said their analysis concluded there isn’t enough demand in the Windham area to sustain a birth center. If the study had concluded it was necessary and possible to do so, the hospital would have had to either find a provider to operate a birth center or operate it themselves.
A freestanding birth center provides a home-like alternative to hospitals, but can only handle low-risk pregnancies. The centers are typically staffed by midwives and doulas, and they do not provide surgical care or anesthesia.
The concept is relatively new to Connecticut. In 2023, the legislature passed a law to allow freestanding birth centers in the state, and to date there is just one, located in Danbury, a spokesperson with the Department of Public Health confirmed.
Each center needs about 115 annual births to break even and 500 births to be financially viable, according to industry benchmarks, the consultants said. The region around Windham wouldn’t meet that demand, they said.
In two different estimates, Guidehouse found the number of eligible births in Windham Hospital’s primary service area that could have taken place at a freestanding birth center in 2023 were 88 and 75. Furthermore, the local population of people who could qualify to give birth at a birth center is decreasing, the consultants said.
Most of the local residents in attendance at Tuesday’s meetings didn’t seem surprised by the findings, given that Windham is located in a rural part of the state.
But during the question and answer portion, they expressed anger at Hartford HealthCare for cuts to services the company has made since its acquisition of the hospital in 2009, including the closure of its labor and delivery unit.
Brenda Buchbinder, a member of Windham United to Save Our Healthcare, a group that has fought the closures at Windham Hospital, said when Hartford HealthCare acquired the hospital, the company promised to bring enhanced services to the community.
“Then what we experienced was slowly but surely regionalizing all of our basic care and making us a shell of a hospital,” Buchbinder said. “The pain of this community is palpable. I think people are watching helplessly as these changes happen and the gutting happens.”
In 2015, Hartford HealthCare announced the conversion of Windham’s critical care unit to what’s known as a progressive care unit, which can’t handle the same complexity of care. In 2023, that unit was closed for 306 days, according to Hartford HealthCare’s
Windham Hospital stopped performing births in June 2020. Three months later, Hartford HealthCare applied for state approval — known as a “certificate of need” — to officially close the unit, pointing to patient safety concerns due to low birth volumes and difficulty recruiting health care providers. The state approved the closure in December 2023.
In an emailed statement, a spokesperson for Hartford HealthCare said the feasibility study and the agreed settlement with OHS “underscore our commitment to a safe childbirth experience, while acknowledging the existing and enhanced pre- and post-natal programs and services we continue to provide.”
Windham Hospital has also enhanced those services, the statement went on, by adding “transportation for patients, a nurse navigator program, a bilingual nurse midwife and improved access to Backus Hospital Birthing Center.” In the last year, the health system has added an urgent care center, opened a substance use disorder center and added other services in Windham, the spokesperson noted.
Windham is just one of three rural hospitals in Connecticut that requested permission to shutter labor and delivery over the last several years. Johnson Memorial in Stafford Springs also received approval to do so, with the same requirement that the hospital’s owner, Trinity Health of New England, hire a consultant to study the feasibility of opening a birth center in the area. The results of that study are still pending.
Sharon Hospital, owned by Nuvance Health, also applied to close its maternity unit, but the state ultimately rejected the application. (Nuvance, which owns Danbury, Norwalk, Sharon and New Milford hospitals, is expected to be acquired by New York-based Northwell Health after the Connecticut Office of Health Strategy approved the deal earlier this week.)
Deidre Gifford, the commissioner of OHS, said Windham Hospital’s agreement with the state also “required the hospital to enhance OB/GYN and women’s health services” in the area, and she said Windham “continues to participate in all compliance monitoring requirements for the other conditions indicated in the agreement.”
OHS is also monitoring the continuity of progressive care unit services at the hospital and said the PCU is currently “open and fully operational.”
The hospital is also required to report to the state demographic characteristics of the pregnant people who receive care at Windham Women’s Health Clinic. Between December 2023 and November 2024, 69 of the 79 patients who gave birth did so at Backus Hospital. Eighty-five percent used self-transport, while 13% were transported via ambulance and 3% used a rideshare.
Roughly 70% of the patients identified as Hispanic or Latino and 37% spoke Spanish. Eighty-five percent received health insurance coverage through Medicaid.
This story was originally published by the Connecticut Mirror.
