Alabama maternity units face closure, leaving many pregnant women in trouble.
Shooting the Stork
By the end of this month, two hospitals in Alabama are set to cease their maternity services, with a third following suit a few weeks later.
This move will not only deprive two counties, Shelby and Monroe, of birthing hospitals but also have significant implications for the predominantly Black neighborhood in Birmingham, which is losing a cherished maternity unit.
Maternity Care Deserts
As these closures take place, pregnant women in Shelby County will have to embark on journeys that are at least 17 miles longer to access a hospital with obstetrics services. Furthermore, the neighboring county lacks a hospital with obstetrics facilities, which means that some residents will lose their nearest birthing hospital as well.
Alabama has been grappling with a dire maternity care situation. More than a third of its counties are considered maternity care deserts, which means they lack essential facilities such as hospitals with obstetrics care, birth centers, OB-GYNs, or certified nurse midwives.
This widespread issue in Alabama coincides with the state having one of the highest maternal mortality rates in the nation, trailing only three other states between 2018 and 2021, as per the Centers for Disease Control and Prevention (CDC).
Additionally, Alabama ranked third in the nation for infant mortality in 2021. The impending closure of maternity units has sparked concerns among physicians affiliated with these hospitals, both current and former.
They fear dire consequences for pregnant women and newborns, especially if there are delays in reaching birthing hospitals during emergencies.
More Babies and Fewer Hospitals
Notably, this is happening at a time when the need for obstetrics care is expected to rise in Alabama due to stringent abortion laws in effect since June 2022, effectively banning most abortions.
The hospitals discontinuing obstetrics departments in Birmingham and Shelby County are part of the Brookwood Baptist Health network, which oversees five hospitals in Alabama.
More Babies and No Doctors
The Brookwood Baptist Health network stated that the decision was made “after careful consideration,” emphasizing its commitment to providing quality maternity care within its network.
Monroe County Hospital has attributed the closure of its labor and delivery unit to a staffing shortage. With only one physician available and a minimum requirement of two, maintaining labor and delivery services has been challenging.
No Health Insurance Means Less Money for Hospitals
In some instances, financial considerations pose challenges to keeping maternity units operational, as these departments are not always profitable.
Approximately 9% of the state’s residents lack health insurance, and nearly half of all births in Alabama are covered by Medicaid. The reimbursements from Medicaid can be significantly lower compared to private insurance plans.
Country Wide Issue
The issue of dwindling maternity services is not unique to Alabama. Nationally, fewer than half of rural hospitals offer labor and delivery services, according to the Center for Healthcare Quality and Payment Reform.
This year has seen the closure of obstetrics departments in several states, including California, Idaho, Massachusetts, and Tennessee.
Research from 2018 reveals that rural counties without obstetric services reported a higher rate of preterm births within the following year compared to counties that retained such care.
Preterm birth is associated with low birth weight, which was the second leading cause of infant death in 2021, according to the CDC.
Lack of Medical Care
In addition to jeopardizing prenatal and neonatal health, the closure of maternity units may discourage patients from seeking medical attention. Living far from a hospital with obstetrics care can deter patients from addressing health issues promptly.
This can result in patients having life-threatening issues without evaluation, further contributing to maternal and neonatal morbidity and mortality.
While Princeton Baptist Hospital in Birmingham is not the sole option for childbirth, it is renowned for its unique approach, which includes welcoming doulas, maintaining a diverse obstetrics team, providing specialized breastfeeding support, and offering water tubs for laboring patients.
The hospital also had the lowest cesarean section rate in Jefferson County as of 2020.
Amidst these closures, patients like Ahna Frye are worried about the impact. She has delivered two babies at Princeton, emphasizing the hospital’s respect for her birth plan and her ability to access Shelby Baptist Hospital in case of complications, given her residence in Shelby County.
However, the impending closures mean her choices will be limited for future pregnancies, and any emergencies will require a significantly longer drive.
Reaction to the article online was split. Some online blamed the people of Alabama, a strongly Republican state, with one commentator stating, “So, they can’t get abortions and now they have nowhere to give Birth. Such a smart Republican legislature.” Another said simply, “So much for pro life.”
The Money Is the Problem
However, others blamed the medical industry itself, with one user commenting, “The funding model is broken. When there are not enough patients that can afford care, even the rich suffer from the closure of hospitals.”
Featured Image Credit: Shutterstock / mikumistock