Correction: A previous version of this story indicated Chatham Hospital President Dr. Jeffrey Strickler was absent from the midpoint meeting on Oct. 17. He was in attendance at the meeting along with Dr. Caesar. The News + Record apologizes for this error.
PITTSBORO — Chatham County has been described as a maternity care desert, meaning services for pregnant women are absent or sparse either through lack of services or barriers to access within the county.
According to the 2021 Chatham Community Assessment, the county ranks last in the state in infant mortality at a rate of 9.4 infant deaths per 1,000 births. Figures are even worse for Black and Hispanic residents — with Chatham’s Black infant mortality rate at 19.4 deaths and Hispanic at 11.2. The state average is 7.0 and the national average is 5.7.
In September 2020, UNC’s Chatham Hospital in Siler City had hoped to address all that with the opening of its $2.6 million Maternity Care Center. The MCC largely achieved its goals, especially for people of color: more than 75% of women giving birth at the MCC have been Black and/or Latino.
But after COVID-19, the “Great Resignation” that followed, nationwide nursing shortages and financial struggles, the future of the MCC now appears uncertain. Less than three years after the center opened, UNC Health says it will likely have to close the center if another nurse resigns.
No official decision has been made about the future of the MCC by UNC Health, but community members have taken action to ensure its continuity.
At an August Chatham Board of Health meeting, Chatham Hospital President Jeffrey Strickler established a 17-member task force that would embark on a 60-day investigation into the long-term viability of the MCC. Those findings were set to be presented to the public next Monday, Dec. 5.
Jen Medearis Costello was one of the community members on the task force and a member of the operational leadership team of Equity for Moms and Babies Realized Across Chatham (EMBRACe), which seeks to ensure successful and equitable birth outcomes for women and babies in the county. She said she believes the work of that original task force has “essentially been disbanded.”
UNC Health spokesperson Alan Wolf said the taskforce still consists of both community members and teammates from Chatham and UNC Health.
“We are incredibly grateful for the time and effort they’ve put into the recommendations they plan to present next week,” Wolf said. “We all share the same goal of creating a sustainable maternity care program at UNC Health Chatham.”
The taskforce members were supposed to meet with Strickler and other UNC Health officials to discuss the direction of the MCC at a midpoint meeting on Oct. 17. While Strickler was in attendance, other UNC Health executive leadership did not attend the meeting, according to Costello. The other UNC Health employee who attended was Audrea Caesar, UNC Health’s chief diversity, equity, and inclusion officer, who was also chosen to lead the task force. This means no member of UNC Health with operational responsibilities was present at the meeting.
Wolf said others were not present because of a misunderstanding.
“They believed their presence was for the December 5 meeting and it got removed from their calendars,” Wolf said.
Strickler did not directly respond to requests for comment in time for publication.
After some UNC Health leaders were absent from the midpoint meeting, Costello, other members of EMBRACe, members of Community Organizing for Racial Equity (CORE) and others formed their own new coalition — The Coalition to Keep the MCC Open.
Stephanie Terry, a member of CORE, said forming the new organization from among members of the various community groups was necessary because no single entity was stepping up to the plate to keep the MCC open.
“What we (the Coalition) continue to ask for is a full and public commitment from UNC to support a thriving MCC for at least three more years,” Costello told the News + Record. “The narrative of lack of volume, that staffing problems are solely related to the Great Resignation, etc., are all false. There is a great need and desire for this unit, and we need Chatham and UNC leadership to stand up for it.”
Costello said the volume of the MCC — the number of people giving birth in the unit — has increased in recent weeks and she says the data shows when the MCC is operating at consistent hours, the outcomes are exceptionally good.
Wolf said leadership at UNC Health remained fully engaged in the discussions regarding the Chatham Maternity Care Center and were briefed by Caesar, Strickler and others after the midpoint meeting, North Carolina Health News reported on Oct. 27 (the story was also published in the Oct. 27-Nov. 2 edition of the CN+R).
The coalition has circulated a petition to show support for the MCC that has generated more than 350 signatures so far. The petition hopes to drum up public support for the MCC and urges UNC Health officials to keep the clinic open for at least three more years.
“The racial and ethnic disparities in birth outcomes for moms and babies in North Carolina are tragic and alarming,” the petition reads. “We believe UNC Chatham Hospital MCC does not need to close, it is a choice.”
The new coalition urged members of the Chatham Board of Health at the board’s meeting Monday in Pittsboro to sign the petition and issue a public statement of support. While the board did not vote to sign the petition as a body, several members said they would sign it individually. The board also created a committee to draft a statement to be released to public following the Dec. 5 presentation by UNC Health.
At 12 p.m. on Monday, Dec. 5, at Central Carolina Community College in Pittsboro, the presentation by UNC Health will be given to the full community taskforce and executives from UNC Health. Several members from the Chatham Board of Health said they plan to be in attendance. Wolf said the meeting is “for members of the taskforce, but they won’t stop others from attending.”
Wolf added that UNC Health wants this to be a transparent process.
At Monday’s BOH meeting, new coalition members also informed the health board that a smaller, UNC-only internal group was created to take all the suggestions from the various community task force committees and distill them for the presentation Dec. 5.
Alisha Bailey, a certified lactation consultant with Piedmont Health and member of the coalition, said the task force was structured according to internal UNC understanding of need, rather than community input.
Costello, one of the coalition members who presented to the health board, said the board has power to do the right thing.
“The bottom line is it can’t be about money,” Costello told the board’s members. “UNC is really pushing on finances right now and they’re making a decision not to prioritize moms and babies.”
She said she believed by choosing not to fund the MCC, UNC Health was making a financial decision to not prioritize families.
UNC Health employees at Monday’s health board meeting said the Chatham Hospital had restructured its finances for fiscal year 2023 and was now operating closer to even margins than previous years — while exact figures were not provided, officials said they estimated Chatham Hospital was earning about $800,000 in annual revenue with about $1.5 million in annual expenditures.
Bailey also said incoming growth to the area — including near the MCC with Wolfspeed and its $5 billion investment coming to Siler City — would bring an inevitable population boom. That means more families in need of maternal care.
“There is so much growth that’s coming to this area,” Bailey said. “There are going to be so many women and families who are going to give birth here in the next 10 years. This is not the time to take away a service.”
Incoming growth, current disparate racial outcomes and a need for rural maternal health are all reasons Bailey, Costello, Terry and other members of the coalition are fighting to keep the MCC open. Terry said the coalition is committed to the cause and will continue to bring attention to the issue.
“We are definitely committed to growing this coalition,” Terry told the health board. “And are steadfast in ensuring that we keep this vital service available for the Chatham that we are today and the Chatham we are in the future.”