More rural hospitals are closing down their maternity wards according to a recent analysis. There has been a decline in hospital obstetrics when it comes to rural areas across the United States. Many smaller hospitals are forced to close down obstetric units because of the high costs involved in keeping these units running. It may seem harder to justify the costly upkeep of these units when you consider the low numbers of babies born in these facilities, but their disappearance poses a risk for people living in these communities.
A small rural hospital can deliver less than 100 babies a year. For the future mothers relying on these obstetrics wards for their prenatal care as well as the deliveries themselves, the fact that many such units are closing can be very problematic. With the nearest hospital being far away, many pregnant women living in rural areas are faced with long drives for prenatal care such as consults, ultrasound examinations, and prenatal vitamins.
Understanding Why Rural Hospitals Are Closing Wards
According to Dr. Neel Shah, who works as an assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School, a labor and delivery unit functions similarly to an intensive care unit. Obstetrics wards typically require a nurse for every patient, so staffing these units can be difficult. Medical equipment requirements can also be high for obstetric wards. All the rooms need to be equipped with infusion pumps, monitors, and other equipment.
Small rural hospitals may also encounter other problems when trying to keep an obstetrics unit running. Many such hospitals may not have an obstetrician on staff. This may force these medical facilities to rely on local family physicians instead. It can also prove difficult to get a significant number of such doctors to fully provide the services needed for a hospital. Another challenging aspect of staffing an obstetrics unit is finding enough qualified nurses with experience in obstetrics care, as they can be scarce.
Generating the revenue that is needed to cover the costs of maintaining these units can also prove to be difficult, as insurance payments are often low. With programs like Medicaid currently paying for just under half of all births in the United States, low insurance payments can become problematic for smaller hospitals. The proportion of people insured by Medicaid is often higher in rural areas. As Medicaid pays roughly half as much as private medical insurance for childbirth, it is harder to keep delivery units open in rural areas.
Finding Solutions for Supporting Maternity Wards in Rural Hospitals
There are several initiatives that can help support labor and delivery services in rural areas. Advocates say that encouraging doctors, nurses, and medical personnel to move to rural areas is a key aspect of keeping obstetrics units open in areas that experience staffing shortages.
A bipartisan bill requiring the federal government to focus on such areas was introduced in Congress last year. The bill would help focus efforts on areas that are experiencing a shortage of health professionals that have specialized in maternity care. Similar initiatives have been introduced before to help other medical care segments such as primary care, dental care, and mental health.
The National Health Services Corps provides loan repayment to primary care providers that agree to serve for at least two years in a designated area that experiences medical staff shortages. The same organization awards scholarships to medical professionals that commit to this practice. The hope behind these efforts is that, once the medical staff participating in these programs have worked in a community and established connections with locals in the area, they will remain settled there.
Another possible solution to this crisis is to expand the use of midwives and birthing centers. As they are generally less expensive than hospital obstetrics units and hiring physicians, they could prove to be cost-effective methods to ensure better access to care for pregnant women. This would help health care providers deal with the lower number of births while maintaining the maternal health care system sustainable.
Why Maternity Wards in Small Town Hospitals Are Important
Rural emergency medical centers are important to local communities. Many people fail to consider, however, that childbirth can often require an emergency hospital visit because of complications or premature births. Small town hospitals may not have the necessary equipment or staff for an emergency health intervention.
Providing local communities with a maternity hospital wing is important. Most pregnant women in the United States receive their prenatal vitamins and care from their obstetricians. This means that, for many women living in rural areas, country side healthcare providers can be few and far between. Pregnant women living in these communities are often faced to drive considerable distances to reach an obstetrics ward. Many hospitals in the countryside have been forced to close the obstetrics wards in their structures because of high costs.
Rural hospitals that still have a maternity care unit may not be able to sustain it because of financial difficulty. It is essential to provide good maternal health care to women in these communities. Not only do pregnant women require prenatal care such as obstetric consults and prenatal vitamins, they are also in need of care during and after childbirth. Complications during labor and delivery may require immediate medical attention. If the nearest obstetrics ward that pregnant women have access to is 30 or 40 minutes away from them, these complications could prove to be life-threatening.
It is not only pregnant women that may require urgent care following a delivery. If a newborn baby suffers complications during or right after childbirth, the absence of a maternity ward could be critical. Research shows that about 500,000 women in the United States give birth every year in rural hospitals, but accessibility to labor and delivery units has declined over the last few years.
A recent analysis of more than 300 rural hospitals has shown that more than 7 percent of them have closed their obstetrics wards between 2010 and 2014. It is important to understand that, as more rural hospitals are closing their maternity wards, the ease of access to maternal care providers for women living in these areas diminishes dramatically.