State health officials have asked operators of a Cary birthing center where three newborns died in the last six months to allow them to inspect patient records and review company policies.
Baby+Co. said Friday it welcomes the review and will work with the state on details.
The company has to agree to an inspection because the state does not require free-standing birthing centers to be licensed, and the state Department of Health and Human Services has no authority to regulate them. The purpose of the review is to understand why the newborns died at, or shortly after, delivery, Mark Benton, deputy secretary of health services, told center manager Ste'Keira Shepperson in a Friday letter.
"I am asking that you voluntarily allow our regulatory staff to conduct an on-site review of your Cary location," Benton wrote. "Doing so will provide the public with the assurance that quality and safety are at its highest levels."
The state has no power to sanction the company. At the end of the review, inspectors would prepare a narrative summary of what they found, a document that would be a public record, Benton wrote.
Baby+Co. halted deliveries at its Cary center as it reviews all newborn deaths there since it opened in October 2014. Four newborns its midwives were assisting with have died out of more than 1,200 births, according to the company. Deliveries in Cary will resume as soon as company officials are assured the facility is safe, but Baby+Co. is not obligated to share the details of its internal review with the public.
In an email Friday, the company said it will work with DHHS to "set a framework for evaluation."
“We have every confidence in our model of care and welcome the opportunity for review," the company said in its email. "We are licensed in the state of (Tennessee) and (Colorado) where there is birth center regulation and regulators from those states have conducted site visits and a careful review of our policies, procedures and safety standards. We apply the same standards across all of our centers, including our center in Cary, NC. We have reached out to DHHS to set a framework for evaluation and look forward to working with them on this as we move forward.”
"It would clearly be in the best interest of future patients, future expectant moms, and the profession of midwifery to find out what has happened," Dollar said.
Birthing centers accept only low-risk patients, so it's unusual to have three newborns die in six months, Dollar said.
"It's far beyond coincidence, we need to find out what has happened," he said. "I would hope that this company, if they are truly committed to the safety of moms and newborns, would agree to fully cooperate with the department investigation so we can know what has gone wrong in these instances and we can find out what needs to be done to ensure that it doesn't happen again."
Baby+Co. has opened facilities in Charlotte and in Winston-Salem, as well as Tennessee and Colorado. Care at the birthing centers is provided by board-certified nurse midwives, according to the company.
Midwives are licensed by the N.C. Board of Nursing and regulated by the state Midwifery Joint Committee.
At minimum, state inspectors would review criteria for patient admission and discharge, check staff credentials, determine the level of medical oversight and supervision, and inspect patient records, Benton wrote. They would want to see files for every stillborn delivered in the last 12 months, and for every infant in those 12 months who died within 10 days of birth. The review would take two to three days.