hospital sign
A hospital sign in West Stafford, Connecticut Credit: Hugh McQuaid / CTNewsJunkie

Connecticut Attorney General William Tong weighed in with concerns Thursday on Trinity Health of New England’s request for permission from state regulators to formally discontinue labor and delivery services at Johnson Memorial Hospital in Stafford. 

Tong submitted a letter to the state Office of Health Strategy, urging the regulatory agency to consider the potential for “unforeseen consequences” for birthing mothers if the rural hospital is permitted to keep its maternity ward closed.

“In the context of pregnant mothers, the closure of JMH Labor & Delivery department will undoubtedly create more strain on transportation for the community’s low-income residents,” Tong wrote. “Even for those who have a reliable method of transportation, the other options are an average of 35 minutes away, which can be a significant barrier for mothers who are seeking consistent prenatal care services.”

The hospital’s executives have argued that they have struggled to maintain trained providers to staff the labor and delivery unit amid years of declining births and that the vast majority of patients travel to Saint Francis Hospital, Hartford Hospital, and Manchester Memorial Hospital for deliveries. 

JMH initially discontinued its birthing services during the pandemic, when an executive order from Gov. Ned Lamont gave healthcare providers greater latitude to temporarily discontinue services without explicit state approval.

Although the order expired in October 2020, the hospital never resumed offering birthing services and did not immediately request a Certificate of Need, prompting regulators to seek to impose a $394,000 fine, which the hospital has contested.

Trinity Health officials made a case for permanently closing the maternity ward during a hearing before the Office of Health Strategy last week, when Dr. Robert Roose, the hospital’s chief administrative officer, said that combination of staffing difficulties and a scarcity of expecting mothers made attempting to operate the unit unsafe. 

“In a low-volume environment with consequently an inability to retain the qualified labor and delivery nursing staff with the appropriate competencies and providers, we can not provide those services safely,” he said.

Johnson’s request coincides with a broader trend in which Connecticut hospital networks have sought to downsize services at smaller facilities and redirect patients to larger hospital campuses. The Office of Health Strategy has recently weighed requests to close labor and delivery services at Windham Hospital and Sharon Hospital.

In his Thursday letter, Tong said that Trinity Health officials had articulated “valid concerns” about staffing difficulties and declining birth rates. However, he said the recent attempts to close labor and delivery units endangered mothers in rural areas of Connecticut. 

“[E]merging research suggests that simply living in a rural area already puts mothers at risk for adverse health outcomes such as maternal morbidity, preterm births, and low infant birth weight,” Tong wrote. “The closure of L&D departments in rural areas only exacerbates the risk of birthing complications, as well as creates additional barriers to time-sensitive care.”

Tong urged the Office of Health Strategy to carefully scrutinize the hospital’s application and balance the benefits of closing the unit against its potential consequences for low-income patients in the region. 

“JMH’s nonprofit status reflects a covenant between the institution and the community and carries with it the obligation to serve the whole community regardless of financial considerations,” Tong wrote. “Given the growing trend of maternity unit closures, I would also urge policymakers to consider what steps might be taken to bolster access to labor and delivery care in the far reaches of our state.”