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On September 18th, the Attorney General of New York Letitia James and her staff held a forum to hear testimony from the Save Burdett Birth Center Coalition members and other concerned community members. Here are some of our testimonies.


Jessica Hayek

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

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.


Lois Uttley

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.


Tisha Graham

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.


Jim Slavin

I am James A Slavin, MD, I practiced orthopedic surgery in Troy for 32 years. I served on the
boards of Northeast Health and St. Peter’s Health Partners (SPHP) from 2004 until 2018. I am a
member of the Unity House Board of Directors, past Chair, and volunteer. I am a board member of the Justice Center of Rensselear County and member of Save Burdett Birth Center Coalition.
In 2011, Samaritan Hospital merged with St. Peter’s Health Partners, Burdett Care Center was
created as an independent separately- licensed hospital, offering maternity and reproductive
services. In 2020, Burdett Care Center closed and was incorporated into the SPHP/Trinity
system. This action stopped the family planning services that had been available at Burdett Care Center.
In the St. Peter’s Health Partners News, on June 23, 2023, Dr. Steven Hanks wrote:
In fiscal year 2022, the losses incurred through operation of the maternity services unit at
Samaritan Hospital, inclusive of providers, anesthesia, and fixed costs, totaled $2.3 million. This is a service we’ve been operating with substantive growing losses annually as birth rates
continue to decline. Our not-for-profit status requires that we serve the community, but it is
imperative we maintain financial viability to ensure we can serve the entire community in the
long term.
In 2021 (the latest available), St. Peter’s Health Partners Form 990, filing reports that for the
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees, Bonus & Incentive Compensation alone was over two million dollars. Benjamin Carter, Director & COO was paid a total of $2,525,463.
In addition, the new Medicare Area Wage Index for Upstate New York should significantly
increase revenue for the SPHP system.
The Birth Center model of care is cost-effective and has better outcomes for Medicaid patients according to a study done by CMS.
“Women who received prenatal care in Strong Start Birth Centers had better birth outcomes
and lower costs relative to similar Medicaid beneficiaries not enrolled in Strong Start. In
particular, rates of preterm birth, low birthweight, and cesarean section were lower among

Birth Center participants, and costs were more than $2,000 lower per mother-infant pair during
birth and the following year.”
There is a body of medical literature that indicates that the midwife collaborative model of care is both cost effective, has improved outcomes and had high patient satisfaction rates.
“The care model’s development and application have resulted in a more team-oriented model
that is widely accepted by providers, nurses, and patients. Over the past 4 years, our practice
has experienced consistent improvement in multiple categories. We have achieved a 42.3%
reduction in primary cesarean sections through enhanced compliance with the ACOG standards
before proceeding with a primary cesarean section. This reduction was accomplished through
implementation of a checklist based on ACOG recommendations. We have increased our rate of successful VBAC section by 12.6%, mostly because of increased recommendation by obstetric providers for a trial of labor after a prior cesarean section. This approach also resulted in a decreased overall hospital length of stay for our patients. We maintained high levels of neonatal safety with only 2 cases of hypoxic ischemic encephalopathy compared with the national average of 2 to 4 cases per 1000 live births. Patient satisfaction with the new care
model has been reported as very high when measured by a nationally accepted survey.”

Closing Burdett Birth Center will significantly affect the quality of life and disproportionately
affect mothers and newborns living in poverty and others who are marginalized in our
The excuse that Burdett Birth Center is a financial burden to St. Peter’s Health Partners/Trinity
is an insult to the mothers and newborns of our community considering the salaries paid to the executives and physicians of St. Peter’s Health Partners/Trinity.
Instead of closing Burdett Birth Center, I recommend that SPHP/Trinity reinvent Burdett Birth
Center as a center of excellence along the line of the Mayo clinic model or the Oula model in
New York City.

Ashley Saupp

Good afternoon, Thank you to the Attorney General’s office for holding this public hearing. My name is Ashley Saupp and I’m the Administrative Director at The Albany Social Justice Center and one of the Organizers with the Save Burdett Birth Center Coalition. I live in Troy and gave birth to my son Ben at Burdett Birth Center just 6 months ago. I was nearly 2 weeks past my due date, something that often happens in first pregnancies and my team of midwives at Capital Region Midwifery just across the street from Burdett were in unanimous support in my decision to let nature take its course –something that’s considered best practice. Because deliveries have turned into an expediency model over a care-first one, other area hospitals would likely have pressured me to induce at 40 weeks, before my baby was ready. Burdett respected my birth plan and we waited.
When it became medically recommended that I be induced, it was the nursing staff at Burdett who were waiting for me and my husband, ready and welcoming to two nervous first time parents. While I had a trying labor, lasting 36 hours, it was the nurses like Lade who held me close, Pam, our midwife who encouraged me to push “just a few more pushes'', Dr. Clements who helped Ben arrive safely and Danielle, a nurse who treated me so tenderly. There were many others but these are the collection of birth professionals who had a critical role in helping me safely deliver my son and for that I will forever be in their debt.
My connection to Burdett is a personal one but I am motivated to be here today because I know Burdett is an essential resource to so many in our community, including medically-underserved families. It would be unconscionable to deny them this incredible maternity care, right in our own city of Troy.
Our coalition knew early on that the closure of Burdett would have a devastating impact and we were not confident that the health equity impact assessment commissioned by St. Peter’s would adequately reflect that. So, we set out to prove the real impact by doing a first-ever
community-led health equity impact assessment that we will be submitting to the NYS
Department of Health later this week. Through an on-line survey, interviews with people who have given birth at Burdett and key stakeholders, outreach at the Troy farmer’s market, along with other community events and hosting our own community forum attended by more than 200 people, gathering of demographic data and consultations with public health experts, the coalition carefully assessed the likely impact on health equity and on medically-underserved people in the Burdett service area.
Representatives of multiple medically-underserved groups – women, racial and ethnic
minorities, LGBTQ+ people, people with low incomes, Medicaid-insured patients, rural residents and people with disabilities – all told the coalition that closure of the Burdett Birth Center would negatively affect their ability to obtain timely, quality obstetric care. The assessment found that 55 percent of Burdett’s patients are Medicaid-insured, as compared to 33 percent at St. Peter’s Hospital, and these people depend on having labor and delivery within convenient reach in Troy.

The travel and timing issues uncovered by the community-led assessment are significant –
longer trips to labor and delivery units from Troy, especially for the many low-income pregnant patients who do not have cars and face either hour-long bus trips to Albany or Uber/Lyft trips of $40 or more that they cannot afford. Medi-cabs must be scheduled and cannot be used for pregnancy emergencies. The Troy Fire Department’s EMS service only has four ambulances and is already overburdened, as you will hear later in this hearing. Residents of Rensselaer County’s more rural areas would face car trips of an hour or more if they have private vehicles, and have no access to buses or to Uber/Lyft pickups. We are especially worried about the risks for people suffering pregnancy emergencies that require immediate care. And, even if patients suffering a pregnancy “scare” could manage to reach a hospital in Albany, they might not be able to get back home that same night if they were stabilized and discharged.
Even if the transportation challenges could somehow be solved – and we found no evidence
they could – the removal of the only labor and delivery unit in Rensselaer County would also
mean the elimination of the only midwife-led, low intervention birthing site in the Capital District.
Women and LGBTQ+ people from Rensselaer County and other locations across the Capital
District – especially those who are Black and Latinx – said they were particularly dismayed at
the prospect of losing a labor and delivery service that they have experienced as culturally
competent, respectful and patient-centered.
Data shared with our coalition show that in 2022, 20.77% of Black people giving birth at Burdett had a cesarean delivery, compared to 41.83% at St. Peter’s Hospital, which is one of the two nearest alternative birthing locations for Rensselaer County residents. The state average for cesarean delivery is 28.9%. Since the NYSDOH has prioritized safe reductions in the rate of cesarean births as a part of improving overall maternal health care in New York, why close the birthing site with the lowest c-section rate in the Capital District?

In conclusion, our Coalition believes that our extensive outreach and assessment of the needs of medically-underserved people in Rensselaer County, as well as the outcry of dismay at the proposed closure have proven without a doubt that this closure would have life threatening consequences for the birthing community of Rensselaer County and the surrounding Capital Region. Based on our research, the closure of the Burdett Birth Center will not improve access to services and health care, will only harm health equity and will further the health disparity gap for the medically underserved communities of Rensselaer County.
It is imperative that we do better than that.

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