Most Rural Hospitals Have Closed Their Maternity Wards, Study Finds

[WhiskeyGrinder]

https://www.nytimes.com/2024/12/04/health/maternity-wards-closing.html

Over 500 hospitals have closed their labor and delivery departments since 2010, according to a large new study, leaving most rural hospitals and more than a third of urban hospitals without obstetric care.

Those closures, the study found, were slightly offset by the opening of new units in about 130 hospitals. Even so, the share of hospitals without maternity wards increased every year, according to the study, published on Wednesday in JAMA, a prominent medical journal. Maternal deaths remained persistently high over that period, spiking during the pandemic.

Because its data runs only through 2022, the study does not account for the additional challenges that hospitals have faced since the Supreme Court case that overturned Roe v. Wade that year and led many states to restrict abortion. States with abortion bans have experienced a sharp decline in their obstetrician work force.

“We’re more than a decade into a severe maternal mortality crisis in the United States, and access to hospital-based maternity care has continued to decline over that entire time period,” said Katy Kozhimannil, the study’s lead author and a professor of health policy at the University of Minnesota.

[WalkerinSC]

1. One of the unspoken reasons

For.closing LDRP departments is the amount of litigation those departments generate versus others.

[bronxiteforever]

7. When things go wrong with a newborn

there are decades of medical bills and treatment required. Litigation for personal injury is tied to life expectancy and projected earnings. A healthy newborn has decades of potential earning which are also built into damages along with medical bills.

See if old and retired people are killed by medical misadventure, they are not worth much. Their lifespan is limited and there are no potential wages to put on the damages board.

You know in America, the value of human life is measured in money.

[SARose]

2. Here in Texas, too

Texas problems are lack of personnel in rural areas and Medicaid reimbursement. The Texas legislature refuses to expand Medicaid access even though we have the most uninsured citizens in the nation.

Some women in active labor are driven over an hour to an hospital with an ER. Some women with preeclampsia are driven 2 hours to access labor and delivery services.

Maternity Deserts: Fewer Rural Hospitals Delivering Babies

[MagickMuffin]

3. "We don't know nothin about birthing babies"

Return of the Midwifes! They’ll have to learn how to birth those babies. Of course if there are complications they could be charged with murder if the baby dies, so, yikes, what’s a nation to do?

[delisen]

4. The MAGA Taliban effect

Pregnancy too risky in USA.

[Solly Mack]

5. K&R

[erronis]

6. When you shut down gynecology/obstetrics you lose pediatricians and then general practitioners, etc.

The ripple effect will happen.

The US healthcare system is being deliberately crippled. Primary care physicians (the old family doctor) are having to try to do more with less. And burnout and low (relative) pay is driving them away.

[bronxiteforever]

8. Kick and recommend

[BumRushDaShow]

9. Not just rural hospitals

but as noted, a number of urban hospitals (mostly the smaller ones) have eliminated maternity wards. I know here in Philly, I have been shocked over the past 20 or so years how many have just dropped them and those that do have them kick the women out a day later (and maybe will keep them up to 4 days if they have a caesarean).