Hospitals have been shuttering maternity wards for years, but the trend seems to have accelerated during the pandemic, especially in rural and Black or Hispanic communities. That will likely hurt health outcomes for rural pregnant women and their babies.
The U.S. "already sees far more deaths per capita among infants and pregnant women than comparably wealthy countries. And during the first year of the pandemic, the number of maternal deaths in the United States rose sharply," Dylan Scott reports for Vox. "Researchers from the University of Minnesota have found when a labor and delivery department closes, there tend to be more emergency deliveries and more preterm births, which are the leading cause of infant mortality."
Rural and minority communities are less likely to have access to all types of health care as it is, including obstetrics. "Before the recent closures, more than half of the rural counties in the United States already didn’t have a nearby hospital where babies could be delivered," Scott reports.
Hospitals cite various factors for closing maternity wards, including declining birthrates and staff shortages. And with fewer births, hospitals worry that staffers' obstetrics skills might get rusty, leading to worse health outcomes for patients, Scott reports.
Finances are also an issue. "Pandemic relief funding that has helped stabilize hospitals’ finances is also starting to run out," Scott reports. "Some hospitals argue that these closures are not financially motivated, but labor and delivery services are not a moneymaker for them. More than 40 percent of births in the United States are covered by Medicaid, and the program’s low reimbursement rates have been cited in the past to explain a hospital’s decision to close its OB department."
Closing a maternity ward can also hurt a community's relationship with the hospital. "There is a fundamental shift in a rural community when a hospital closes its OB unit," University of Minnesota professor and maternal mortality expert Katy Backes Kozhimannil told Scott. "It’s like a place where you can’t even be born. You can only die. The sense of that is really palpable."