Monday, January 28, 2019

Small towns pay price when hospitals quit delivering babies

Struggling rural hospitals are increasingly cutting obstetric services, because there are fewer rural babies being born these days, it's difficult to attract OB/GYNs to rural areas, and such services are expensive to provide and insure, the latter because legal costs are high: childbirth-related incidents are the fifth-largest source of malpractice claims.

What all that adds up to: Fewer than half of rural counties in the U.S. have a hospital where a woman can deliver a baby, and that's caused big problems for communities and families in rural areas, especially those who are poorer, minorities, or depend on public assistance, Catharine Richert reports for Minnesota Public Radio.

Minnesota Public Radio map; click the image to enlarge it
Richert reports from Grand Marais, near the state's northeastern corner, where a pregnant woman and her husband had to drive four hours southwest to Duluth in the middle of the night during a blizzard when her water broke. The hospital in Grand Marais stopped delivering babies more than three years ago.

From 2000 through 2014, "15 of the state's rural hospitals stopped delivering babies in that time — a nearly 38 percent decline," Richert reports.

The decrease in rural birth services has increased stress for pregnant women and their partners. "One recent University of Minnesota study found a huge jump in anxiety when the Grand Marais and Ely hospitals stopped providing labor and delivery services in the summer of 2015," Richert reports. "Women who received prenatal care locally reported a tenfold increase in anxiety from 1990 to 2016, the year following the closures."

Some in the study reported feeling like second-class citizens, and felt that government did not care as much about rural residents, Richert reports.

The lack of birthing services isn't the only problem for parents of newborns in rural areas. Parents have a hard time accessing certain medical services for infants that are commonly available in urban areas. Matt Tyler, a forester who lives in Grand Marais, said he and his partner Erin Petz had to take their newborn to Duluth to treat his jaundice, but their car broke down before they could get there. "There is a big gulf" between the availability of health care in urban and rural areas, he told Richert. "If we want our rural communities to be strong and to carry on, that gulf needs to get closed somewhat, because otherwise these communities are going to die if there's no way to have babies here."

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