I was never much interested in health care administration. I preferred the immediate gratification of bedside care. I was a clinician. Nonetheless, I was considered the leader of our three-person midwifery service by virtue of my seniority. 

Instead of a stunning blue designer suit, such as Lady Aylward wore to her 1970 meeting with Poplar’s Board of Health, I wore a white lab coat over scrubs in 2001 when called to meet with the leaders and administrators of the hospital that owned the Family Birthing Center (FBC). This is the same besieged setting described in my blog entry for episode 1. 

The nurses, doctors and midwives had been questioned for weeks by representatives of a consulting firm hired by the hospital to assess legal risks and make recommendations. I would like to think that I was as prepared, as sharp and as articulate as Trixie Aylward, but the truth is, it didn’t matter. Those of us who loved the FBC knew the result was predetermined. It’s the money; it’s always the money. 

“In that the Family Birthing Center is not the standard of care for births in this geographic area, it presents an unnecessary legal risk. We recommend care and births at this facility be suspended,” the Chief Medical Officer reads from the final report. 

He looks up at the nurse leader of the FBC and me to gauge our reaction. MaryLou and I look at each other and shrug. The FBC was kept open for over 20 years longer than was wanted by the administration. We tried our best. He continues.

“Don’t worry,” he waves his hand, seeming to sweep us away. “We plan to build an alternative birthing unit in the hospital. It will be better, safer and prettier. In fact, it will be great.”

Promising “better” and “great,” while taking away choice and autonomy, is often uttered by those dictating changes not wanted by people knowing they are being gaslit. Great for who?

An undercover ally had overheard information about a counter agenda prompting this action. “Closing the FBC frees up its budget, leaving a surplus,” said one suit to another. “That puts us in a good position for the department to come in under budget, meaning a nice bonus for both of us.” 

Our spy describes their triumphant grins and patting each other on the shoulders. I have no confirmation it’s true, but it feels like it could be. Our nurse leader, MaryLou was terminated, despite her positive performance ratings, her salary freed up to be scavenged. 

Our community of supporters, including families who had birthed at the center, nurses, midwives, childbirth educators, doulas and lactation consultants, showed up in front of the hospital with signs and marched in protest to the FBC closure. The press and TV news stations came and took statements and video. But little, if anything, made the news that night, as a Jet Blue airplane crashed at Detroit Metro Airport the same day as the protest.

They closed the place where the nuns had slept and then so many had birthed, and they opened the Alternative Birth Center (ABC) in the postpartum unit at the end of the hall. In truth, it was lovely, with whirlpool tubs, queen size beds and homey decorations. And it was closer to physician supervision.

As Trixie Alward announces the news that Nonnatus House will live to fight another day, Sister Julianne responds, “No. We live to serve.”

And so those of us who fought for women’s autonomy during labor and birth at the Family Birthing Center lived on to care and carry that mission into another place. And the fight goes on.