During the first months of the pandemic, the whole world watched a video of people lined up outside Elmhurst Hospital in Queens. Against that backdrop, Elmhurst Hospital midwives have cared for women of all ages. The hospital serves a very large immigrant community, with patients from more than 20 countries receiving care at the facility. The midwives have cared for COVID-19-positive mothers and babies during the pandemic, delivering more than 400 babies, and they continue to do so.

Scenes of overcrowding on hospital floors were shocking. The story had many dimensions, but at its core is the underfunding of the New York City public hospital system, resulting in severe disparities and the segregation of health care, with inequitable death rates by race as the harsh reality.

Once a unit of 15, the midwives were down to just seven, an indication of the enormous demands of the job. There is much more to midwifery than delivering babies. In fact, the range of duties Elmhurst midwives carry out is astonishing.

Multiple responsibilities

Delivering babies is just one of their responsibilities. They see every pregnant person who comes through Elmhurst’s doors and they also run the gynecological clinic down the street from the main facility. They teach midwifery students, medical students and OB/GYN residents and offer counseling to every woman from adolescence to menopause.

The seven are on the Mount Sinai payroll but work at Elmhurst Hospital, the busiest in the New York City Health + Hospitals system. They voted to join NYSNA on March 21, 2019. Keeping experienced midwives was a major priority in bargaining, and that meant keeping a lid on overtime and getting a pay raise. Over the course of a decade, the midwives have received just one pay raise.

COVID-19 overwhelmed their bargaining, and long delays ensued. The midwives and management returned to the negotiating table this year, and the midwives won a major victory, ratified on August 3.

A successful battle

“There are few things in life that, after doing battle and being worn down, you feel were worth it. I am happy to announce that the battle we fought as NYSNA nurses with Mount Sinai Services at Elmhurst was one of the outliers and worth it,” said Margo Re, CNM, who has worked there for 23 years. “Thanks to NYSNA for encouraging us to persevere. I am happy, relieved and proud that our two and a half-year battle has come to an end … and in our favor. May all our battles in the future be as successful!” said Re.

“We are all so relieved to finally have a contract that will allow us to retain the amazing midwives in our practice and recruit new ones,” said Keeley McNamara, CNM. “We would like to thank all the NYSNA members, politicians, community activists and members of the Elmhurst and Mount Sinai community for supporting us through our negotiations.”

[Excerpted from letter of support, to Dr. Kenneth Davis, President and CEO, Mount Sinai Health System, signed by 22 Elmhurst doctors, July 29, 2021]

As you know, H+H/Elmhurst Hospital Center is a 500+ bed public hospital situated in the “epicenter of the epicenter” of the COVID pandemic in Queens. Mount Sinai physician faculty and midwives have been on the frontlines. Elmhurst serves one of the most diverse regions in the country, and cares for a large undocumented and uninsured population. In this context, we have historically had up to 15 midwives serve this population; as a direct result of our failures in pay and work equity and refusal to fill empty positions, we are down to only 7.

The decimation of the midwifery practice at Elmhurst Hospital has implications in racial and gender inequities across our care, training, and research mission. In care delivery, the loss of midwives has an extraordinarily negative impact on our diverse and marginalized population we care for in obstetrics and gynecology. Midwives have a broad scope of practice and play a critical role in delivering high quality care for low-risk obstetrics, family planning, and preventative gynecology. Research has demonstrated the central role of midwives in improving the quality of care and maternal health outcomes. If the communities in our public system do not have access to midwives, while those in the private Mount Sinai system do, we are furthering the segregation of healthcare and disparities that persist in NYC.