R.I. Hospital files with state to open obstetrics unit

RHODE ISLAND Hospital recently submitted a Certificate of Need to the R.I. Department of Health, seeking approval to build a $43 million obstetrics unit. / COURTESY RHODE ISLAND HOSPITAL
RHODE ISLAND Hospital recently submitted a Certificate of Need to the R.I. Department of Health, seeking approval to build a $43 million obstetrics unit. / COURTESY RHODE ISLAND HOSPITAL

(Updated 12:48 p.m.)
PROVIDENCE – Rhode Island Hospital, a Lifespan hospital, Tuesday submitted a Certificate of Need to the R.I. Department of Health, seeking approval to build a 31-bed obstetrics unit.

In its application, the hospital is proposing completing the obstetrics unit in 2020 at a cost of $43 million to build. If approved, the new unit will include 25 postpartum beds, six antepartum beds and eight labor and delivery rooms.

The application filed Tuesday with DOH updates an earlier version, filed in January 2016 and later withdrawn in October 2016 by Rhode Island Hospital. The hospital had notified DOH it would resubmit a new application.

Rhode Island Hospital called obstetric care increasingly complex, with more medical issues, such as cardiovascular disease, diabetes, hypertension and obesity, facing more pregnant women and new mothers. With these medical complications, there’s evidence, it reported, such women face increased complications giving birth.

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“While most women experience healthy pregnancies, chronic illnesses, delayed childbearing and other factors have led to an increased prevalence of obstetric complications such as hypertensive disorders, pulmonary embolism and many other problems,” said Dr. Margaret Miller, chief of women’s services at Rhode Island Hospital and director of Lifespan’s Women’s Medicine Collaborative. The obstetrics unit, if approved, would offer a full range of services for pregnant women, including services for women who want a more holistic experience as well as for those who are considered high-risk or who experience an unexpected pregnancy complication. Women will have better access to experts and specialized care from cardiology to hematology, surgery and more, improving and ensuring coordination between OB/GYN doctors and these specialists, the hospital reported.

Rhode Island Hospital’s nearby medical neighbor is Women & Infants Hospital, a Care New England facility, that delivered approximately 8,800 babies last year. The two facilities, along with Rhode Island Hospital’s pediatric division, Hasbro Children’s Hospital, are located in close proximity near Eddy Street in Providence.

Mark R. Marcantano, president and chief operating officer of Women & Infants Hospital, one of the largest stand-alone obstetrical services in the nation, told Providence Business News, “We think [Rhode Island Hospital’s application is] an unnecessary duplication of services, and it will undermine our world-class hospital for women and newborns that we have built for the citizens of Rhode Island and beyond. We’ve worked very hard to do that; we see [Women & Infants Hospital] as a state gem. … Any attempt to create duplicative services in the state of Rhode Island … is absolutely not needed and it undermines our ability to deliver that world-class service.”

Late last year, Women & Infants filed its own Letter of Intent, a precursor to filing a Certificate of Need, seeking to renovate its labor and delivery suite, currently comprised of 19 private labor/delivery/recovery rooms, three dedicated Cesarean birth rooms and a recovery area, and an Alternative Birthing Center that offers a high-touch, home-like, midwife-led birthing experience for low-risk births. The proposed renovations, said Women & Infants Hospital, will consist of renovating all 20 labor rooms and increasing the room size from 220 square feet to the current guidelines of 400 square feet with a private bathroom and shower in each room.

The renovation, with a projected cost of approximately $18.6 million, is scheduled to be completed in October 2018 and will be done in phases over 14 to 16 months in order to minimize any disruption to existing service.

In making the argument for adding an obstetrics unit, Rhode Island Hospital noted that patients not only will have access to urgent OB/GYN, medical and surgical services all in one location, but will also be able to access the comprehensive array of services Lifespan offers to proactively manage chronic illnesses such as diabetes and obesity. Nationwide, nearly 90 percent of academic, full-service teaching hospitals – including all five teaching hospitals in Boston – provide obstetric services as part of their clinical offerings, recognizing its critical importance to the delivery of integrated care to women and children, the hospital reported.

“The goal is very clear: Improve the health of women and their children across their lifetimes,” Margaret M. Van Bree, president of Rhode Island Hospital, said in a statement. “We are moving to better serve women and their children in our community at a time when changes in the population of women needing care require a new and more comprehensive approach – one that is also cost effective.”

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