This commentary is by John Puleio of Middlesex. He is a retired educator living in Middlesex, and is married with three grown children raised in Vermont.
Lamoille County’s Morrisville-based Copley Hospital has developed one of the most successful orthopedic centers in the state of Vermont. This high-quality and sought after service has become a gem of this small critical-access hospital.
A newly opened beautiful facility on the nearby Waterbury campus is proof positive that when a service is valued for its success and contribution to health for an increasing number of patients, the service can grow and become an economic engine for the overall benefit of the hospital. Appreciable salaries and generous bonuses demonstrate this success and allow for the sustainability of top-notch practitioners.
Not all services within an institution such as Copley can be large income generators in the manner of the highly specialized offerings of orthopedics. Think of care for infants within early child care centers. Because of high staffing costs, this service is a well-known net income loser. Costs and revenue come into balance because care of preschoolers — in the same setting — is less costly. Not such a naive apples-to-oranges comparison considering that one keeps the other viable while the school as a whole is sustained.
The critical and vital services provided by Copley Hospital’s birthing center could be the beneficiary of the success of orthopedics while adding to the continued viability of the hospital.
It’s quite well known that birthing centers, particularly small rural ones, are not money makers. Never have been. That’s hardly the reason why hospitals have maintained such essential services birthing centers have always provided.
Health care is a birth-to-end-of-life proposition. Birthing centers serve as gateways to future care and relationships for people that hospitals have an obligation to serve. If we look at profitability as the sole rationale to possibly close Copley’s birthing center, we miss the opportunity to grow the value, prominence and attractiveness of the birthing center. Like Orthopedics, it could be a brighter gem in its crown.
Profitability is not the only factor that makes a center shine, and there is certainly room for growth. According to UVM’s Vermont State Data Center, Lamoille is one of the counties in Vermont that shows population growth. And from the Vermont Department of Health’s vital statistics report, Lamoille County had the second-highest birth rate per 1,000 residents in 2022. As has been widely publicized, the March of Dimes 2024 report scored Vermont as the only state with an A grade in maternal and newborn health outcomes.
Surely Copley’s midwifery model — one of three in the state — contributes to this high grade. Midwifery care can be one of the safest, most cost effective means of managing pregnancy and birth. A 2023 Yale School of Medicine paper concluded “that many measures of successful pregnancy are elevated when midwives play a central role.” Certainly this care has led Copley to have one of the lowest cesarean section rates in the state.
In truth, efforts to simply maintain the birthing center are not enough. Additional efforts to engage consultants to review all management practices and not just at the Birthing Center may yield efficiencies and savings.
Moreso, a vision that puts full force into promoting the birthing center’s exceptional track record, improving the facility to make a beautiful space, honoring nurses as essential links to the vitality of our families, innovating to expand wrap-around services and fully marketing the birthing center can only lead to expanded use and prominence as a leading center of care.
As a gateway and as an exceptional midwifery model, the success of the birthing center could well contribute to the overall value and sustainability of Copley, thus proving itself to be an essential community-affirming crown of multiple jewels, and a model for Vermont.
A decision to keep the birthing center open would show a dedication to the belief that the center is core to the mission of Copley. A decision to keep it alive would highlight its exceptional care and its vital role and importance to the local community’s health and economy.
This decision to save the birthing center would not be possible without a willingness to show a supreme commitment to the care for women, newborns and families, despite the monetary limitations. All of the above are excellent reasons to urge Copley’s board of directors to stand up for sustaining and growing the birthing center.
