Grassroots push

Missoula mom urges hospital to end midwife ban

| November 12, 2009

When Nici Holt Cline first heard that her midwife, Jeanne Hebl, had been banned from Community Medical Center (CMC), she wanted to know why. Cline, who is nine months pregnant with her second child, feared that if she had to be transferred to the hospital during her birth, that Hebl would not be allowed to go with her. Searching for straight answers, Cline went straight to the source and scheduled an appointment with the doctor in charge of CMC.

"The hospital sells itself as striving to meet patient needs from day one," she says. "I wanted them to show me."

Nici Holt Cline, nine months pregnant with her second child, recently met with Community Medical Center officials to question their ban of her midwife, Jeanne Hebl. Just a week after the meeting, in which Cline presented a stack of letters in support of Hebl, CMC reached out to Hebl to resolve the issue. - PHOTO BY CATHRINE L. WALTERS
  • Photo by Cathrine L. Walters
  • Nici Holt Cline, nine months pregnant with her second child, recently met with Community Medical Center officials to question their ban of her midwife, Jeanne Hebl. Just a week after the meeting, in which Cline presented a stack of letters in support of Hebl, CMC reached out to Hebl to resolve the issue.

Cline met two weeks ago with Dr. Jonathan Weisul, chief medical officer of CMC, and Janell Hemsley, head of women and children's services at the hospital. During the meeting, Cline says she told the CMC officials that women in Missoula want options when it comes to birth, even if those women are birthing at a hospital. She told them women should be allowed to have their chosen practitioner by their side. She also said that by ignoring women in the community and their desires when it comes to birth, the hospital was not fulfilling its promise to make patient concerns the cornerstone of care. Cline then handed Weisul and Hemsley a stack of support letters from Missoula women who had birthed with Hebl.

"This is about a patient-centric policy at the only hospital in town where women can deliver babies," Cline says. "On the most fundamental level, not allowing a practitioner that a woman chose to be with her while she is birthing goes against everything we know about creating trust in the most intimate of circumstances. It goes against everything we know about birth...Obviously, right now, I'm personally driven. I'm nine months pregnant and planning a home birth with Jeanne, but this is bigger than me."

According to Hebl, Weisul and CMC's Chief Executive Officer Steve Carlson notified her last month that she was no longer allowed on the hospital's campus. Hebl, who has assisted with births in Missoula for more than 15 years, says she was accused of crossing the lines in patient care. She denies any wrongdoing and CMC has never publicly released the specific allegations.

The timing of the ban also raised eyebrows—shortly before being confronted by CMC, Hebl announced plans to open a new birth center on Missoula's south side.

CMC continues to refuse comment on the Hebl situation and did not return repeated calls from the Independent for this story.

But it appears Cline's efforts may have created a breakthrough. After her meeting with Weisul and Hemsley, Hebl says CMC contacted her about working out a solution to the issue. Hebl met with CMC officials on Nov. 5

"I was able to respond to the allegations, and when Dr. Weisul realized there were differences in the stories, he didn't dwell on it," Hebl says. "He said basically, 'Let's go forward and see how we can work together.'"

Specifically, Hebl says Weisul presented her with a written document that outlined what she could and could not do as a birth attendant. Hebl says the policy, which does not single out Hebl, but covers all doulas, midwives and other support staff, is fair.

"I was pleased with how the meeting went," Hebl says. "I think we came to a common understanding."

Hebl says CMC must get the physicians in its maternity ward to sign off on the new policy before it is finalized. CMC told Hebl that a staff-wide meeting would take place Nov. 20.

The apparent agreement between Hebl and CMC comes after a tumultuous two years for supporters of alternative birthing options. Hebl helped start Missoula's first birth center with Lynn Montgomery, an obstetrician-gynecologist and perinatologist,

in 2006. While working with Montgomery, and for more than 10 years prior, Hebl had privileges to treat patients and help them deliver babies both at the center and at CMC.

But Montgomery died of a heart attack last October at the age of 51, and the subsequent closing of his birth center left patients with few alternatives to birthing at CMC. Hebl began attending home births and, in the meantime, was unable to find another physician willing to sponsor her for hospital privileges. CMC eventually purchased the birth center building, but did not continue the same services at the facility.

Hebl opened her new birth center last month to help fill the void, providing women an alternative to home and hospital births.

The recent developments between Hebl and CMC have Cline breathing easier—even if those breaths come through the occasional contraction. Cline hopes she can stick to her birth plan and labor at home, but if problems arise and she must go to CMC, she at least feels better about going to the hospital with Hebl at her side.

"I was impressed [Weisul] took a meeting with me and took it seriously," says Cline. "With situations like this I wanted to show that good ol' grassroots activism gets things done...Who knows if it had anything to do with them contacting Jeanne, but I like to think that the effort we put into this will help effect positive change at the hospital."

Comments (6)

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Thank you so much to Nici Cline...Jeanne is my midwife, too...My first daughter was delivered at CMC by Jeanne and it was a very good experience...I didn't feel I wanted to trust my prenatal care and birth of my 2nd daughter (due march 1st) to anyone but Jeanne...I was really upset when I found out what was going on...Largely because I wanted to give birth at CMC but with Jeanne there...but even more so it really bothered me on a personal level that someone as skilled, careful, and caring as Jeanne would be kicked out of my own version of my ideal birth plan because of some political reason. Thanks again Nici

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Posted by brandy on 11/30/2009 at 9:44 PM

Thank you for the great article and a big thanks to Nici and all the other supporters of Jeanne. It is so nice to see that the word is still circulating and the support great. Here's to Jeanne and CMC accepting the new policy.

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Posted by jodeez on 11/13/2009 at 4:25 PM

I'm expecting a child this winter and I'm really glad to see that Community is creating a fair and reasonable set of expectations for all birth attendants. If I need to transfer to the hospital for some reason, it will be a huge relief for me to know that all the people that care for me understand their roles in the process.

So to all the OBs out there- PLEASE accept this new policy, for the sake of all Missoula health care providers, babies, and expectant moms and dads. Cooperation is the KEY!

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Posted by M.M. on 11/12/2009 at 12:56 PM

I love our town. Thank you, Nici for all your efforts; you are a wonderful advocate for women! Thank you also to the Independent for reporting and staying on top of the issues that matter to Missoulians.

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Posted by Ekalaka on 11/12/2009 at 10:48 AM

Great article is right. Congratulations to Nici Holt Cline and all the other mothers to be who will benefit from her efforts and beliefs.

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Posted by Joan Cline on 11/12/2009 at 8:33 AM

Great article!

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Posted by trbholt on 11/12/2009 at 7:50 AM
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