After 30 years, this rural hospital reopened its maternity unit

Dana Iglesias, medical director of the UNC Health Chatham Maternity Care Center, left, and Beverly Carpenter, the unit's manager, stand inside a labor and delivery room. (Photo by R. Crumpler, NC Health News)

UNC Health Chatham in North Carolina closed its obstetrical unit in 1991 after years of staffing shortages and poor financial performance. For 30 years, moms and families had to drive farther for care and delivery, while UNC hospital leadership continued to work on how to make maternity care fit in a rural hospital setting. 

After decades of consideration, UNC hospital leadership and medical providers decided to alter their obstetrical unit's staffing structure to make it more versatile and affordable. UNC Health Chatham reopened its mother-baby unit in 2020. Rachel Crumpler of NC Health News reports, "Births at the unit have increased each year since it opened, reflecting demand for local maternity care."

The unit is created to be sustainable and flexible. Crumpler writes, "It serves low-risk mothers and newborns and is staffed by family physicians trained in obstetrics and surgery, along with midwives — a lower-cost model than one centered on OB-GYNs, who cost more to employ and are harder to recruit to rural areas." 

Because family medicine doctors are trained across multiple medical specialties, their versatility helps them meet the two-patients-at-once demands of obstetrical care. Additionally, their salaries are lower than OB-GYNs, "meaning delivery volumes don’t need to be as high for the unit to be financially viable," Crumpler explains.

The unit's unique staffing structure and service model may offer a blueprint for other rural hospitals. Jesus Ruiz, a family physician at the Chatham Maternity Care, told NC Health News, "Chatham is a template, but it’s not a copy-and-paste template. . . .This shows a way that rural maternity care can be built and sustained.”

UNC Health Chatham leaders are working to spread the success of their model. Crumper adds, "Eric Wolak, the chief operating officer at UNC Health Chatham, said he’s fielded calls from other community hospitals — within and outside the UNC Health system — asking about the family medicine-driven model and Chatham’s implementation."