Inside Elmhurst Hospital midwives’ fight to unionize

Keeley McNamara has worked as a midwife for NYC Health + Hospitals/Elmhurst for more than a decade and has gotten only one pay raise.

With a salary under six figures, McNamara said, she earns about $40,000 less a year than new midwives at Mount Sinai, the same system that cuts her paychecks. She gets no pension, no paid time off specifically for sick days and no premiums for overtime pay.

McNamara said she stays because she loves her job and the hospital, but it is difficult to retain midwives and hire new ones. In her time at Elmhurst the number of midwives dropped by more than half. Her team has eight midwives, all employed by Mount Sinai’s Icahn School of Medicine through an affiliation with the city’s public hospital system. Together, they work about 48 hours of overtime a week.

“We’re just stretched super, super thin and we need more people,” she said.

The situation motivated McNamara and her fellow midwives to vote two years ago to join the New York State Nurses Association, which represents 42,000 nurses, including at Elmhurst.

They have since pitched Mount Sinai two proposals, McNamara said, but they have yet to secure a contract. She said the midwives feel Mount Sinai is stonewalling them.

“Mount Sinai management has failed for more than two years to offer the midwives a fair contract,” said Carl Ginsburg, a union spokesman. “The time to respect these midwives is long past due.”

A Mount Sinai spokeswoman called the accusation of stonewalling “disingenuous” and claimed the midwives have gotten “fairly regular annual increases over the past few years.” She said the system will present the union with a counterproposal Thursday that has been approved by Health + Hospitals, which must sign off on any contract with the midwives.

Health + Hospitals spokesman Christopher Miller said they hope to reach an “amicable resolution” with the midwives.

“Women’s health is important at NYC Health + Hospitals/Elmhurst, and our midwives’ role is important in that care experience,” he said in a statement.

The negotiating process kicked off in 2019, with Elmhurst’s midwives first requesting the same terms granted to Mount Sinai Hospital’s midwives. Margaret Re, Elmhurst’s chief midwife, said the system refused.

Earlier this year midwives at Health + Hospitals/North Central Bronx secured their own union contract, like what Elmhurst’s midwives envisioned.

Elmhurst’s midwives handed Mount Sinai a copy, McNamara and Re recalled. They arranged a meeting in May to discuss it, Re said, but Mount Sinai canceled. She said Mount Sinai also canceled their rescheduled meeting, set for mid-July, because the health system had not yet reviewed the proposal.

Mount Sinai’s spokeswoman said negotiations proceeded slowly because of the pandemic and the time it took for the union to respond. NYSNA, she said, “had not made an economic proposal.”

The spokeswoman said Mount Sinai met in June to look at the midwives’ latest proposal—the one modeled off the Bronx midwives’ contract—but Health + Hospitals still needed to review it. Mount Sinai tried to schedule a follow-up meeting, the spokeswoman said, but the midwives declined.

Last weekend the midwives collectively started refusing to work overtime—an act of protest to prove their indispensability and secure a fair contract, Re said.

Re, who has worked at Elmhurst for 23 years, said their demands include a starting salary around $100,000, incremental raises for cost-of-living increases, a pension and better health benefits.

McNamara said short staffing has already forced them to cut programs, like group classes in prenatal care. She hopes a union contract will help the midwifery team return to adequate staffing levels and provide patients with better care.

“We’re not asking for anything crazy,” she said.