My name is Jessica Hayek. I have been a birth worker in the Capital Region, for the
past 11 years. I’m certified as a Birth Doula, Childbirth Educator and Lactation
Counselor. I am a resident of Troy/Brunswick.

As a birth doula, I support families wherever they choose to give birth. Hospital, home,
or Birthing Center. I have witnessed births in all settings in the Capital Region and I
have attended births at every hospital. Doulas have that unique perspective - we see it
all. I know that Burdett Birth Center is a unique place and there literally is nothing else
like it. Burdett provides birthing people, a midwifery-led collaborative model of care.
Burdett is on the top of my list when a client needs a recommendation for providers. In
choosing Burdett, families will experience individualized care. Care that looks at the
entire picture of what their specific needs are. At Burdett, I have only witnessed birthing
people’s minds and bodies respected during the childbirth process. They are given
space and time for choice and consent. When people feel safe, and are given this type
of care, they are healthier and happier.

The midwifery-led model of care is what sets Burdett apart from other facilities. It
minimizes interventions, monitors the physical, psychological and social well-being of
the birthing person throughout the childbearing cycle; provides education and
counseling during the prenatal period; offers hands-on assistance for labor and birth;
provides postpartum support and offers referrals for obstetrical care when necessary.
For my clients who fall into that small percentage needing need surgical intervention to
bring their babies into the world, Burdett’s obstetricians provide stellar surgical skill and
expertise. Around the world, midwives attend approximately 70% of all births. The
countries with the lowest maternal and infant mortality and morbidity rates are those in
which midwifery is a valued integral part of the maternity care system.

When I talk with my clients, in appointments or in a class setting, we talk a lot about
options. Families are encouraged to explore what is available to them for support
during this profound time in their lives. Should they choose an epidural? Should they
choose hydrotherapy? What about a Water birth? Will they choose an Obstetrician?

Midwife? The thing about Burdett is that people have access to whatever they may
need to bring their babies safely and joyfully Earthside. At Burdett, birthing people have
access to a full range of options, that is not available at any other medical center in our
community.

Back in June, when Saint Peter’s Health Partners made the closure announcement, the
birth community was stunned. Capital Region Birthworkers know the high quality of
care people receive at Burdett. We know the Midwifery Model of Care results in better
outcomes for moms and babies. The midwifery model results in lower c section rates,
lower intervention rates and lower maternal and infant morbidity and mortality rates. We
were stunned because closing Burdett goes against all the efforts being put forth to
improve maternal health. Why would you close a facility that is meeting and supporting
the goals set by entities like The World Health Organization, Healthy People Initiative,
The United Nations, National Institute of Health, Us Office on Women’s Health and The
New York State Department of Health. These initiatives include reducing maternal
mortality and morbidity, reducing infant mortality and morbidity, increase breastfeeding
numbers and taken from NYSDOH Prevention Agenda Action Plan). One of the goals
listed is “reduce racial, ethnic, economic and geographic disparities and promote health
equity”. Closing Burdett would make these disparities worse not better.

This is taken from the Surgeon General’s Call To Action
“Every medical appointment or interaction with health care professionals is an
opportunity to ensure that standards of care and the full needs of women are being met.
Given the vast diversity in geography, economy, and racial and ethnic make-up of
communities across the U.S., healthcare professionals can ensure that the care they
provide is scientifically-sound and culturally appropriate to the individual and their
respective community.” This is midwifey-led care. Midwifery care is Evidence-based,
scientifically sound, wholistic, culturally appropriate, gender affirming, family centered,
woman centered, birthing person centered care. The Midwifery-led model values
patient consent, informed decision-making, and individualized care. All birthing people
deserve this model. All birthing people deserve to be approached as unique individuals

during the amazing time of life that is pregnancy and birth. As a doula in this
community, I know that Families in the Capital Region deserve to keep Burdett as a safe
option for their care. I know that people will be harmed if it closes. Hospital
conglomerates that are based in another part of the country should not be allowed to
dictate what choices families have here, in our part of the country, in NY, in Rensselaer
County, in Troy. We know what our community needs, because we are the community.
We know that Burdett Birth Center must not only stay open, but must be preserved,
supported, funded and protected, so it can continue to provide excellent, safe, life-
saving maternity care.

Good afternoon. I am Lois Uttley, founder of the statewide coalition called Community Voices for Health System Accountability (CVHSA). I have more than 25 years’ experience tracking hospital consolidation and helping communities protect access to key services, including maternity care, when hospitals are merging, downsizing or closing. I am grateful for the opportunity to urge the state Attorney General to hold the St. Peter’s Health Partners
accountable for its responsibility to preserve timely access to high quality labor and delivery
services here in Rensselaer County.
The proposed closure of the Burdett Birth Center at Samaritan Hospital by the St. Peter’s Health Partners system would violate the promises St. Peter’s made to this community when it took over Samaritan Hospital in 2011 and created the separately-licensed Burdett Care Center to preserve access to comprehensive reproductive health services. It would also violate promises St. Peter’s made in 2020 that ending the Burdett Center’s independent status and absorbing it into Samaritan Hospital would preserve access to maternity care in Rensselaer County.
The closure would appear to violate the non-profit charitable missions of both St. Peter’s
Health Partners and its parent Trinity Health System. As Catholic health facilities, they are
governed by the Ethical and Religious Directives for Catholic Health Services, which emphasize the importance of “the biblical mandate to care for the poor” and to provide care for uninsured, underinsured and otherwise vulnerable and marginalized people.
Despite a mission to serve the poor, St. Peter’s is proposing to close a birth center where 55%
of the patients are insured by Medicaid, and in a city (Troy) where more than 25% of the
population lives in poverty and 22 % of the households have no cars that could be used to
drive to other hospitals.
The proposed closure of Burdett is only the latest example of what can happen when a
community hospital joins a large regional or national health system. These systems promise
community hospitals they will improve the quality of care and bring financial viability.
Unfortunately, it is often the case that neither of these promises comes true. Community
hospitals acquired by these large systems have often been forced to shutter ERs, inpatient
psychiatric care, dental clinics and -- of particular relevance to this public hearing -- maternity
services. Patients who were accustomed to receiving acute care services in their own

communities have been forced to travel to the “hub” hospitals in these systems, which would
be St. Peter’s Hospital in this case.
Can St. Peter’s really not afford to keep maternity care in Rensselaer County? St. Peter’s

parent Trinity Health System is the third largest Catholic health system in the nation and sixth-
large private health system overall with more than a hundred hospitals. The system has total

assets of $31 billion3, and pays its President more than $3 million a year.
Think about that for a minute. A system with $31 billion in assets, whose President earns $3
million a year, says it desperately needs to shut a birth center in Troy in order to save $2
million a year!
In fact, financial statements for the year ended June 30, 2022, show Samaritan Hospital
breaking even on operating expenses and revenues. By contrast, St. Peter’s Hospital reported a $43 million loss on operating income for that same year. And Trinity has recently reported an operating loss of $298 million.
Why not cut services at money-losing St. Peter’s or in the top ranks of Trinity administrators?
Clearly, having joined St. Peter’s Health Partners and the Trinity Health System has not helped to protect access to services at Samaritan Hospital.
I was one of the New York health advocates who pushed for a new state law requiring
independent assessments of the likely impact on medically-underserved people and on health equity when health facilities are proposing to reduce or eliminate services.

The people who rely on the Burdett Birth Center include the very groups of medically-
underserved people whose health care needs are prioritized under the health equity impact

law: women, LGBTQ+ people, racial and ethnic minorities, immigrants, people with
disabilities, people with low incomes, people with Medicaid insurance or no health insurance
and rural residents.
Because this is the first health equity assessment to take place in New York State, I’ve been
watching it closely. The firm hired by St. Peter’s to do the assessment has done a cursory job
and does not appear to have fully realized the requirement for “meaningful engagement” of
the affected community.
Instead of listening to the Save Burdett Coalition’s two-hour presentation of data, individual
birth stories and comments from stakeholder organizations on Aug 23, Chartis employees
stood outside the forum and tried to get people to fill out a poorly designed on-line survey.
They gave people only five days to fill it out, but then extended that after I and local officials
complained to the NYS DOH. The survey initially did not ask whether the respondents were
members of a medically-underserved group, so there was no way to tell whether the survey was actually gathering comments from the very groups of people for whom the assessments are supposed to identify likely negative impacts on their access to care. Those questions were added later, but in a confusing format. The consulting firm never met with the Save Burdett Coalition to hear their concerns.
Anticipating this situation, the coalition working to save Burdett Birth Center decided to do its own community-led health equity assessment, which is nearly complete and will be
submitted to the state Department of Health shortly.
You will hear from members of the coalition in detail today about the key findings of their
health equity impact assessment. You will also hear from some of the individuals who
responded to the coalition’s on-line survey, or who spoke out at the coalition’s community
forum. I want to close by giving you the inescapable conclusion of the community-led
assessment: Closure of the Burdett Birth Center will do nothing to improve health equity and
much to harm it. I urge you, as Attorney General, to protect this community from that harm
and prevent the closure of the Burdett Birth Center.

As a person in the Capital Region who wears many hats regarding both birth work and
birth advocacy, I thank you for the opportunity to testify today regarding the proposed
closure of the Burdett Birth Center in Troy, NY. I come before you as someone who, for
the last three and half decades, has been a provider of clinical, physical, educational
and emotional care and support of pregnant people, as well as an activist, fighting for
the reproductive rights of families and their babies, specifically as those rights relate to
the access of the Midwifery Model of Care.
Why? In short: Midwives Save Lives – the midwifery model at Burdett centers on
individualized, compassionate and collaborative care with far fewer interventions which
result in more favorable outcomes which ultimately decreases mortality and morbidity of
the most vulnerable populations of people living in Rensselaer County. Black and Brown
birthing people, whose birth experiences and clinical outcomes are far worse than those
of their white counterparts, have far better outcomes, with greater health, wellbeing, and
satisfaction, as do their babies, when cared for in the collaborative midwife/OB model
that Burdett offers.
The universal reaction of outrage and disbelief in the birth community, in Rensselaer
County, and in the greater Capital Region as word spread of the proposed closure of the
Burdett Birth Center took the shape of the Save Burdett Birth Center Coalition, of which
I am a proud member. This broad coalition of individuals and organizations, politicians
and labor leaders, health care providers and families represent just some of the many
stakeholders who are committed to keeping the Burdett Birth Center open.
Why? Because what we have here in the city of Troy is a unique place with stellar
statistics and a compassionate staff – from custodial and nutritional service providers, to
techs, students, nurses, midwives and doctors, all working together to provide a positive
and respectful experience for all who look to Burdett for care. As a doula who has
attended hundreds of births at Burdett over many years, I can personally attest to the

experience of JOY that families experience when they give birth at Burdett. I want to
testify today about joy in birthing, and how joy translates into empowerment.
Joy is the result of an experience that fosters shared decision making, agency,
autonomy, choice, voice, freedom from coercion, being treated with respect, and having
a healthy outcome. Joy increases satisfaction with the birthing experience which results
in greater success with breastfeeding and lower incidences of postpartum anxiety and
depression. Joy, then, translates into empowered parents, healthier babies, happier
families and stronger communities. Being empowered by birth is every pregnant
person’s birth right – feeling empowered through agency, ownership, choice and voice
(to be seen, to be heard, to be listened to, to be respected) is what helps new parents
start out strong in their parenting journey. Pregnancy impacts labor, labor impacts birth,
birth impacts parenting, parenting impacts families, families impact communities.
Families who birth at Burdett experience joy and empowerment.
Not to mention that healthier families equal healthcare savings.
We don’t often look at healthcare savings through the lens of low interventions, far
fewer surgeries, less operative deliveries, more vaginal births, and higher VBAC rates -
all of which result in greater success with breastfeeding and with happier, healthier
mothers and babies. When a healthcare conglomerate such as Trinity Health
determines one of its facilities should close because they are LOSING money – they are
punishing providers and a facility for managing maternity care correctly – for having
better outcomes, for lowering healthcare costs, for saving money!
What generates money in maternity care is more frequent and often medically
unnecessary use of common interventions and higher surgical birth rates – what puts
birthing people at risk is more frequent and often medically unnecessary use of common
intervention and higher surgical birth rates. It’s an old story. One that puts profits before
people. We call upon the Department of Health to recognize that maternity care that
relies on LESS medical management rather than MORE medical management creates
a community where healthcare thrives. This is especially true for a community that has
been historically disenfranchised, disrespected, dismissed, and ultimately denied
access to optimal outcomes.
Burdett Birth Center does birth well, they do birth right. They should be the example of
what we want and need more of, not less of. Burdett must remain open. It is a shining
example of optimal health care, and it has a direct and positive impact on the wellbeing
of our communities. To close it would be unconscionable and criminal and will have a
dramatically negative impact on the residents of Troy, of Rensselaer County, and of the
entire Capital District. We know what constitutes the best care. Please, Madame
Attorney General, help us to protect it.