A growing number of rural hospitals have shuttered their delivery units, forcing pregnant women to travel for care or face giving birth in an emergency room, reports the AP. Fewer than half of rural hospitals now have maternity units, prompting government officials and families to scramble. One solution gaining ground is freestanding midwife-led birth centers, but those often rely on nearby hospitals when complications arise. The closures have worsened so-called "maternity care deserts"—counties with no hospitals or birth centers that offer obstetric care and no OB providers. More than 2 million women of childbearing age live in such areas, the majority of which are rural. Ultimately, doctors and researchers say, having fewer hospital maternity units makes having babies less safe.
One study showed rural residents have a 9% greater probability of facing life-threatening complications or even death from pregnancy and birth compared to those in urban areas—and having less access to care plays a part. "Moms have complications everywhere. Babies have complications everywhere," says Dr. Eric Scott Palmer, a neonatologist who practiced at Henry County Medical Center in rural Tennessee before it ended obstetric services this month. "There will be people hurt. It's not a question of if—simply when." The American Hospital Association says at least 89 obstetric units closed in rural hospitals between 2015 and 2019, with more since.
The main reasons for closures are decreasing numbers of births; staffing issues; low reimbursement from Medicaid; and financial distress, says Peiyin Hung of the University of South Carolina's Rural and Minority Health Research Center. Officials at Saint Alphonsus hospital in Baker City, Oregon, for example, cited a shortage of OB nurses and declining deliveries in closing its maternity ward. "We will not sacrifice patient safety," reads an email from two leaders from the hospital. Read the full story, which notes that some states and communities are taking steps to create the aforementioned freestanding birth centers. For example, Connecticut Gov. Ned Lamont signed legislation that will license such centers and allow them to operate as an alternative for low-risk pregnancies.
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