A Tale of Two States: When the money runs out


Women who are pregnant and who are preparing to deliver babies are experiencing a great challenge and barrier to care. More hospitals are closing their Labor and Delivery units.  Recently, two hospitals in Bonners Ferry, Idaho and Emmett, Idaho announced that they would no longer be delivering babies.

Since 2011, 217 hospitals in the United States have closed their labor and delivery departments, according to a report by the health care consulting firm Chartis. Services provided at maternity units vary from hospital to hospital. Most offer obstetrics care in which an obstetrician will deliver a baby, either vaginally or via cesarean section. These units also provide perinatal care, which is medical and supportive care before and after delivery.

Other services provided may include lactation specialists and private delivery rooms.

This presents a great hardship to women and their families. Expectant mothers now must drive great distances to get appropriate OB/GYN care causing risk of complications, births by the side of the road, or pregnancy terminations.

So, what is the driving force behind the phenomena of these maternity units closing?

According to the American Hospital Association, 42% of births in the US are paid for by Medicaid, which has low reimbursement rates. Employer-sponsored insurance pays about $15,000 for a delivery, and Medicaid pays about $6,500, according to the Health Care Cost Institute, a nonprofit that analyzes health care cost and utilization data. (Ibid)

Clearly, the slow rate of reimbursement for Medicaid deliveries is causing physicians and hospitals to reconsider if operating these units is even viable anymore.

We are witnessing the growing reality of maternity unit deserts.

What is the situation like here in Texas?

Texas is the national leader in maternity ward closures. In the past decade, more than 20 rural hospitals have stopped delivering babies. More than half the state’s rural counties don’t even have a gynecologist.

Again, this creates a tremendous hardship for women, their partners, their families. This hardship is especially true for poor women, especially those located in more rural, more isolated areas.

What can be done?

First, people need to contact their state house representatives and state senators and demand that Medicaid reimbursement for maternal deliveries be dramatically increased to prevent further hospital closures and to forestall further erosion of physicians providing OB/GYN care and services.

Politicians are forever fond of portraying themselves as committed to “family values? “

Where is the commitment to “family friendly “policy when women cannot get to a hospital in a reasonable distance to deliver a baby, or they cannot find s physician to take care of them?

Easter is a season where we celebrate the rebirth of nature, the growth of new life in Spring.

Why can’t we do a better job in supporting women who are bearing new life into the world?

We can do better.

We need to do better.

Our future depends upon us doing better by women, men and for families.

May it be so.

Rev. Peter E. Bauer is a United Church of Christ minister and has been a regular contributor to the Huffington Post and Medium.Com.


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