WeNews correspondent
January 21, 2011
More women of child-rearing age are uninsured and dependent on medical
assistance. That is tightening the financial noose around hospital maternity
care and causing longer waits and travel time for pregnant women.
(WOMENSENEWS)--In
August 2009 more than 100 people, mainly woman, gathered in the parking lot of Summa
Wadsworth-Rittman Hospital
in Wadsworth, Ohio--a
town of 20,000 in the northeast part of the state--to protest the threatened
closing of the maternity ward there. Two months later it was gone.
Fast
forward to December 2010 and another crowd of about 100, most of them nurses
working at the John C.
Lincoln Hospital
in Phoenix. They were rallying in
front of the hospital to stop the closure of the obstetric unit there. Most of
those nurses will be out of work in early February, when the hospital proceeds
with plans to close its birthing facilities.
The number
of maternity wards that are closing across the country are hard to track. But a
Google Internet search shows the flashing lights of protests and outcries in
numerous U.S.
communities. From New Jersey to Washington
state, in urban and rural areas, maternity services are at risk. In 2008, about
4.2 million infants were born in the U.S.,
down slightly from the 4.3 million the year before--not a sufficient number to
explain the closings.
Major
explanations are high medical malpractice premiums in this specialty and a
rising dependence on Medicaid reimbursement, which cover, on average, 88
percent of the actual costs.
Health Care Coverage
Decreasing
Amid a
tough recession, the numbers of women of childbearing age who lack private
health care coverage rose by 1.3 million between 2008 and 2009, according to a
September 2010 report by the Guttmacher Institute, a New York-based reproductive
health researcher. In 2009, 22 percent of all women of childbearing age were
uninsured and almost 15 percent were on Medicaid, according to Guttmacher.
Chicago,
meanwhile, provides an overall indication of the rising level of need for
public medicine. The Metropolitan Chicago Healthcare Council, a hospital trade
association, says hospitals in the Windy
City provided $1.2 billion in free
care in 2008, a 16-percent jump from 2007.
Those
overall cost pressures are particularly hard on maternity care.
In Pennsylvania--where
approximately two-thirds of births are covered by medical assistance and the
Medicaid reimbursement rate is below the national average at 82 percent--39
hospitals have closed their maternity wards since 1997. That leaves the
remaining wards bursting at the seams and women suffering delayed care.
In the
northeastern Pennsylvania town of Montgomery, expectant mothers covered by
Medicaid have to wait 11 and a half weeks, when their first trimester is almost
over, before they see an obstetrician, says Letty Thall, policy director at the
Maternity Care Coalition, a Philadelphia-based maternity and infant health
advocacy organization.
Similar in Other
States
A spot
check of other states finds similar problems. For example, in New
York City at least five hospitals have ceased
providing maternity care since 2003.
In Alabama,
the number of hospitals performing obstetrics has declined to a current 32 from
58 in 1980, according to a report by the University
of Alabama.
In Kentucky,
according to the Center for Rural Health, a research department at the University
of Kentucky, for every 100,000 rural Kentucky
residents, there are an average of seven obstetricians, compared to 11 in the
metro areas of the state.
In September
Mary Breckinridge
Hospital in Hyden, which provided maternity care
to mothers living in the Appalachian Mountain region of Kentucky,
closed its maternity ward. It was the only hospital in the area that promoted
natural birth. Expectant mothers must now travel an hour or more for prenatal
and birthing care.
Kelli
Haywood is the only Lamaze-certified childbirth educator in the mountain areas
of eastern Kentucky. She says
most hospitals who service multiple counties have only one or two obstetricians
on staff.
"I
have heard of woman giving birth on the side of the road," she says.