People left scrambling as rural maternity facilities close

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A lack of money was the major reason why Henry County Medical Center in Paris, Tennessee, closed its OB unit. CEO John Tucker told The Associated Press that it was a necessary financial step to sav…

Alisha Alderson placed her folded clothes and everything she needed for the last month of her pregnancy in various suitcases. She never imagined she would have to leave the comfort of her home in rural eastern Oregon just weeks before her due date. But following the abrupt closure in August of the only maternity ward within 40 miles, she decided to stay at her brother’s house near Boise, Idaho — a two-hour drive through a mountain pass — to be closer to a hospital.

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.

“The results are devastating when safe staffing is not provided. And we will not sacrifice patient safety,” according to an emailed statement from Odette Bolano and Dina Ellwanger, two leaders from the hospital and the health system that owns it. Private insurance pays hospitals more — the median topped $16,000 for cesarean sections in Oregon in 2021. State data shows that’s more than five times what Medicaid doles out.“When volumes go down, losses actually get bigger because so much of that cost is really fixed,” he said. “Whether we’ve got one baby on the floor or three, we still staff at the same level because you kind of have to be prepared for whatever comes in.

Evans’ office and exam rooms contain bulletin boards covered with photos of infants she’s brought into the world. During a recent visit, Katie O’Brien of Paris handed her a new photo of her son Bennett — the third of her children Evans delivered. The two women cradled the baby and hugged. Alecia McGregor, who studies health policy and politics at the Harvard T.H. Chan School of Public Health, called midwife-led birth centers “a major sort of contender among the possible solutions” to the maternity care crisis.

 

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