 |
| Jewish Hospital in Shelbyville, Ky. was cited for turning away a woman in labor |
"Some ERs not only denied treatment to women in labor, they also would not help them transfer elsewhere, records show," Lasson writes. "A woman turned away by Monroe County Hospital in Forsyth, Ga., ended up calling 911 from outside the dialysis center across the street. Another woman, told there were no staff gynecologists at a Hartford, Ky. hospital, called an ambulance from a grocery store parking lot."
"EMTALA was passed primarily to ensure that emergency rooms couldn't refuse patients because they couldn't pay for services," Lasson writes. "Prompted by a catastrophic case in which a pregnant woman was turned away from two California hospitals that believed she had no insurance, the provisions outlined in EMTALA specific to labor reflected that a growing number of hospitals, especially in rural areas, had begun eliminating obstetrics departments because of high costs and a lack of doctors."
A study by The Walsh Center for Rural Health Analysis found that the number of non-metro hospitals lacking hospital-based obstetric services was 44 percent in 2002, up from 24 percent in 1985, Lasson writes. "A study by the University of Minnesota Rural Health Research Center found that 7 percent of hospitals in nine states with large rural populations closed their obstetrics units between 2010 and 2014."
While some of the cited hospitals have made changes, not all have, Lasson writes. "Government inspectors cited East Texas Medical Center Carthage in Carthage, Texas, for a July 2012 incident in which a staffer told a woman in labor that the hospital didn’t have obstetric services or an obstetrician, and didn’t know where ambulances were stationed to transfer her elsewhere. She and her husband tried to drive themselves to another hospital, but their car broke down, the inspection report said." The baby died. "As part of their investigation, inspectors turned up an email from one Carthage staff member to another, noting this was not the first time the medical center had turned away an emergency delivery."
In order to ensure that emergency rooms of U.S hospitals couldn't refuse patients because they couldn't pay for services , the federal Emergency Medical Treatment and Labor Act (EMTALA) was passed. This law required every hospital in the U.S with an emergency room to treat and provide care for patients who arrive in labor, at least until their baby is born. It is an absolute abomination that there has been at least 20 rural hospitals in the past five years found in clear violation of the EMTALA, which was passed thirty years ago. Not only did these hospitals turn away women in labor, but many of them would not help them transfer elsewhere for care at an alternative facility.
ReplyDeleteWe can clearly see that this issue is unique to rural populations when we look at a study by The Walsh Center for Rural Health Analysis, which found that the number of non-metro hospitals lacking obstetric services was 44% in 2002, which is a dramatic increase from 24% in 1985. Additionally, the University of Minnesota Rural Health Research Center discovered that 7% of rural hospitals with large rural populations shut down their obstetrics departments between 2010 and 2014. These efforts to get rid of obstetric units most likely are due to the hospital trying to lessen the instances where women in labor show up in need of their care, and is also the result of the lack of doctors in rural areas, especially those specializing in OB.
It is difficult to accept the reality that the women denied access to care from these rural hospitals suffered serious complications after being turned away, and many lost their babies as a result of this. This is both an ethical and moral issue that needs to be given more attention so that more people will become aware. This issue doesn't necessarily directly affect urban populations, since this scenario is much less likely to occur in urban areas. Also, if this situation were to happen in an urban area, transferring to a different health facility after being turn away would be much easier and more successful due to shorter travel distances in urban areas compared to those in rural areas.