If all goes according to plan, one of the seven rooms in the maternity ward at The Westerly Hospital Friday simultaneously will be the scene of a joyous beginning for the Tuthill family and a sad ending for a community institution.
That's the day Jennifer Tuthill is scheduled to give birth to her and her husband James' third child, after Jennifer is induced a week ahead of her June 8 due date. The birthday will happen on the last day the 125-bed, 91-year-old hospital will exist as a standalone community hospital before it officially becomes part of the larger Lawrence + Memorial Hospital, and also the final day for its maternity ward.
As of June 1, Westerly Hospital will no longer have an obstetrics department, a decision made during the year the hospital was in receivership that is widely viewed as an unfortunate but necessary step in maintaining its financial viability.
"We're very happy to have the opportunity to stay at Westerly Hospital," said James, as the couple's 4-year-old son, Jamie, snuggled next to his mother in the living room of their Mystic home, while his 2-year-old brother Ian napped.
"But it's very sad they're closing it down," Jennifer added.
Dr. Robert Greenlee, the last remaining obstetrician at Westerly Hospital, will deliver the baby. Unless one of his patients goes into labor early and unexpectedly ends up at Westerly Hospital instead of L+M, the Tuthill baby likely will be the last delivery in the 65-year-old doctor's career.
After June 1, Greenlee will provide prenatal, postpartum and gynecological care at his Westerly office and at Westerly Hospital, while pregnant patients will be directed to L+M in New London for deliveries. Two obstetricians and two nurse-midwives from New London-area practices will see pregnant patients in the same Westerly office a couple of days a week.
"Labor and delivery should be the showcase of a community hospital - it seems kind of incomplete without it," Greenlee said. "But this is happening at small hospitals all over the country. L+M is trying very hard to make this seamless. But it is bittersweet. This is a business, and we have to get used to that."
In each of the past few years, about 350 babies have been born in the maternity department at Westerly Hospital, far fewer than the 1,000-per-year considered the minimum number for sustainability, Greenlee noted. Even at its peak - about 550 to 600 births per year in the early 1990s - the numbers at Westerly Hospital weren't high enough.
For the Tuthills, the decision to stay at Westerly Hospital was easy. Jennifer Tuthill said she's been seeing Greenlee throughout her pregnancy and knew she wanted him to deliver her baby. She previously had been induced - a practice allowed after 39 weeks of pregnancy - when her second child was born and James, a lieutenant commander in the Navy, was scheduled to leave on a submarine deployment.
After the announcement this winter that the Westerly Hospital obstetrics department would close, the couple toured L+M and The William W. Backus Hospital in Norwich, but neither felt right.
"They just felt clinical," James Tuthill said. "Westerly didn't feel like all cold, white tile and fluorescent lights. We knew we'd get personal attention there."
Their experiences with their first two children, they said, were a key factor. Jamie was born in a large, "cold and antiseptic" hospital in South Carolina, James Tuthill said. Ian came into the world in a small community hospital in Maine.
"The experience in Maine was a lot easier on Jennifer, and Westerly mimicked that," he said.
The distance, too, was a factor. The drive from the Tuthills' home to Westerly Hospital takes about 20 to 25 minutes. L+M can take 35 to 40 minutes, James Tuthill said, depending on traffic.
Dr. Andrew Neuhauser isn't surprised that a few minutes of travel time made a difference to the Tuthills in choosing a hospital. Until March, he had been Westerly Hospital's second obstetrician, but he moved his practice to South County Hospital in Wakefield so he could continue delivering babies.
"I had to make a decision about where I wanted to spend my last five or six years, and I wanted to continue doing deliveries and I wasn't fond of moving my practice to Connecticut," Neuhauser, 61, said. "Nobody likes a huge change in their life this late in their career, but I'm trying to make the best of it."
Most of his patients, he said, have followed him, opting to have their babies at South County mainly so they could be born in Rhode Island instead of Connecticut, preferring the drive on Route 1 to Wakefield over a trip on Interstate 95 over the Gold Star Memorial Bridge to New London.
Since March 1, he's delivered about 30 babies at South County.
Neuhauser plans to open a Westerly office in the coming weeks and offer appointments there two days a week. He has continued assisting with deliveries at Westerly Hospital and will be on hand if needed through midnight Friday.
"I felt obligated to help out," said Neuhauser, a town resident who came to Westerly Hospital in 1990 after serving as a Navy physician. "But I'm obviously saddened. Obstetrics is the gateway to hospital services for many families, and closing it is bound to have ripple effects on other services."
Westerly pediatricians, for example, will no longer be able to visit newborn patients at the local hospital, he said, and the hospital's anesthesiologists will no longer have requests for their services at cesarean section births.
"I mean no ill will to L+M," Neuhauser said, "but this has got a bit of emotion about it. It's obviously going to be sad. I'm going to miss the nursing staff at Westerly Hospital immensely. We've become like family."
To prepare for the change, Greenlee has been helping train the emergency department staff at Westerly Hospital in how to handle pregnant patients who show up there, using computerized mannequins provided by L+M that "deliver" mannequin babies.
"The emergency staff has been undergoing intensive training," he said. "They're concerned about what's going be coming in, people who are bleeding at 34 weeks and don't realize there's no OB department. The ambulance corps has also been informed not to bring patients in labor here, and to offer to bring them to L+M or South County."