Rep. Susan Johnson (D-Windham) speaks at a rally against the then-proposed closure of the labor and delivery unit at Windham Hospital. Shahrzad Rasekh / CT Mirror

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Original reporting by Katy Golvala. Compiled by Gabby DeBenedictis.

On Dec. 1, Connecticut’s Office of Health Strategy announced the approval of a plan to terminate labor and delivery services at Windham Hospital, bringing an end to a three-year saga that pitted community organizers against one of the state’s largest health systems.

Windham Hospital stopped performing births in June 2020. Three months later, Hartford HealthCare, which owns the hospital, applied for state approval — known as a “certificate of need” — to officially close the unit.

In July 2022, OHS issued an initial denial of the proposal. But Hartford HealthCare appealed the decision the following month, giving it the opportunity to present additional evidence and conduct another round of oral arguments. The state approved the labor and delivery unit closure following that process.

Two other rural Connecticut hospitals are seeking to end birthing services as well, and the state has yet to reach a final decision on their proposals.

Here’s what to know.

Why did Hartford HealthCare want to close Windham Hospital’s labor and delivery unit?

The health system has pointed to patient safety concerns due to low birth volumes and difficulty recruiting health care providers.

In its appeal to OHS’ initial denial of its closure, Hartford HealthCare stated, “The proposal at its core is about patient safety and the need to close a labor and delivery service that can no longer operate in a safe and consistent manner.”

The health system has presented findings from a survey where hospital administrators reported “needing at least 200 annual births for safety and financial viability.” Hartford HealthCare noted that “Windham handled approximately 100 births in each of its last several years of operation.”

Experts agree that concerns about patient safety are valid but that it has become a common reason hospitals give for closing labor and delivery units, often without sufficient evidence.

“That’s an important consideration, but there are also ways around it. And it’s sometimes used because it’s easier to say than ‘We just can’t make it work financially,’” Katy B. Kozhimannil, a professor of public health policy at the University of Minnesota, said in a 2021 interview with The Connecticut Mirror. 

Kozhimannil added that the relationship between patient safety and birth volumes isn’t clear.

“The work that we have done looking at the relationship between birth volume and quality of care in rural hospitals has shown a mixed bag. There are a lot of ways in which low-risk childbirth is very well done in low birth volume settings,” she said. 

Why did advocates protest the closure of Windham Hospital’s birthing unit?

The issue of low birth volumes at Windham has been one of the most contentious points of disagreement between Hartford HealthCare and community members opposed to the closure.

“It comes down to both sides saying it’s unsafe,” said John Brady in a November 2021 interview with The Connecticut Mirror. Brady is a registered nurse and serves as the executive vice president of AFT CT, a union representing health care professionals, as well as teachers and public employees.

“We say it’s unsafe for people to have to travel down Route 32 or up Route 6 [if the unit closes]. They say it’s unsafe because there’s a low number of births. We say, there’s a low number of births because you made that happen,” he said.

At a rally last month calling for the restoration of services, Willimantic town council member Rodney Alexander called the closure “how you kill a small city.”

“How can you convince a young couple to move to Willimantic, raise a family, with no maternity ward?” Alexander said.

Where can Windham area patients give birth now?

The closest hospital with a birthing unit is Backus Hospital in Norwich, located about 17 miles southeast of Windham.

What are Windham Hospital’s responsibilities in the closure?

Under the terms of the settlement, Windham Hospital must hire an independent third party to assess the need for and feasibility of establishing a birthing center in the area. If the study concludes that it is necessary and possible to do so, the hospital will have to either find a provider to operate a birthing center or operate it themselves.

“Together with Windham Hospital, we carefully crafted this settlement to ensure the healthcare of birthing parents is not compromised by the termination,” said OHS executive director Deidre Gifford in a statement.

The hospital will also be required to provide both emergency and non-emergency transportation for the birthing parent, as well as any support people, to and from the hospital for pre-delivery exams, labor and delivery, and post-delivery visits. Windham Hospital will continue to provide prenatal and postpartum care.

“[Our] coalition remains committed to ensure this agreement is appropriately implemented and that HHC’s executives are fully accountable to its requirements,” read a statement from Windham United to Save Our Healthcare, the community coalition leading the opposition against the closure.

What is the status of the other proposed rural birthing unit closures?

Sharon Hospital, which is owned by Nuvance Health, applied to close its labor and delivery unit in January 2022 as part of a broader effort to align services to the aging population it serves, said Andrea Rynn, a spokesperson for the health system.

In August 2023, OHS initially denied Nuvance’s application. The hospital appealed the decision and, last month, presented oral arguments. Per the certificate of need process, OHS should issue a final decision within 90 days. Sharon Hospital has continued performing deliveries while it awaits the state’s decision, the only hospital of the three to do so. 

Johnson Memorial stopped performing births in April 2020, though it briefly resumed services for a few months that year. The hospital, which is owned by Trinity Health of New England, applied to close its labor and delivery unit in September 2022 and OHS held a public hearing in July 2023. The agency has not yet issued a proposed final decision.

If the two closures receive state approval, only one of Connecticut’s four rural hospitals — Day Kimball in Putnam — would offer birthing services. Windham and Litchfield counties would be left with one labor and delivery unit each, and Tolland County would have none.

Related Stories:

  1. CT approves closure of labor and delivery at Windham Hospital
  2. Awaiting state decision, advocates protest proposed Windham Hospital birthing unit closure
  3. Battle over Windham Hospital birthing unit enters final stages

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