Rural Hospital Maternity Crisis
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More Than Half of US Rural Hospitals No Longer Offer Birthing Services
More than 200 hospitals in rural areas of the US have closed up shop on labor and delivery services over the past 10 years, according to a recent report. The result: more than half of rural hospitals no longer offer birthing services. And as hospital expenses increase, patients in rural areas may face even greater difficulties accessing maternity care, leading some experts to declare a state of crisis. This according to a article in the JAMA
The report was prepared by the Center for Healthcare Quality and Payment Reform (CHQPR). There are both workforce and financial challenges.
In 10 states, more than two-thirds of rural hospitals do not offer labor and delivery services as of January 2024, noted the CHQPR report, which is based on data from the Centers for Medicare & Medicaid Services (CMS) Healthcare Provider Cost Reporting Information System and hospitals. In Florida, the state with the highest percentage of rural hospitals without maternity care, only 3 of 21 facilities outside of urban areas still offer these services.
The gaps in rural maternity care mean that patients must travel long distances to reach the nearest hospital that can serve them. The travel time to a hospital with labor and delivery services in rural areas is likely to be at least 30 minutes, though it’s often 40 minutes or more, according to the report. That’s in contrast to less than 20 minutes in most urban areas. In New Mexico, the median driving time to a hospital with obstetric services is 61 minutes and in Alaska it’s more than 90 minutes.
Mothers and babies can die if they can’t get to a hospital that can deliver the baby in a timely fashion. Remember that.
How Did We Get Here?
There are several problems at play. In states that have restricted abortions, Ob/Gyns are leaving. We saw that Idaho can attract no new ob/gyn residents and a large number have moved out of state. It just isn’t safe to practice there. Second, maternity services are not often a profit center. That means that staff and resources need to be available but are not used sufficiently to make them pay for themselves. Since they are not self sufficient they are often closed. We have seen this over and over when private equity investors take over rural hospitals.
Recommendations
The report recommends that state Medicaid programs and private providers increase what they pay. That might help some hospitals, but the real issue is that the hospital does not support sufficient births. The real answer is two fold. First make it safe for doctors to go to work by legalizing abortion nationwide. Second, implement a regional authority to make sure that infrastructure is paid for in the hospital.
That way the hospital is not dependent upon volume of births, but will have sufficient funds to have staff and facilities available as needed. What a concept. It has a name. It is called Global Budgets and is a part of HR 3421 the vastly improved Medicare for All Act. I refer you to section 611 of the text.
ACTION
Let’s let our Members of Congress and Senators know about this shameful situation. Let’s also remind them that women and babies lives are at risk in rural areas and that restoring the right to reproductive healthcare and implementing Universal Healthcare can save lives. Their contact information is in the Resources section below or you can use RESISTBOT on your cell phone and text SIGN PSXUFP to 50409 to send the message below.
“I am your constituent and I want you to know about a new report from the Center for Healthcare Quality and Payment Reform. Here is a link to their report on maternal care in rural America. https://ruralhospitals.chqpr.org/downloads/Rural_Maternity_Care_Crisis.pdf.
It is shameful. More than 200 hospitals in rural areas stopped offering labor and delivery in the last 10 years and more than half of rural hospitals no longer offer birthing services. The more time it takes to get to the hospital the more at risk the mother and child are. Part of the problem is that labor and delivery is not a profit function, the other is getting the doctors to be present. It is a complicated problem but, Good News, you can help fix both problems.
First make it safe to be an OB/GYN by passing the Women’s Health Protection Act (S. 701/H.R. 12) so that doctors don’t leave states that threaten to put them in jail for caring for their patients. Those doctors are the ones best suited to handle high risk pregnancies. NEXT, make sure the hospitals have enough money to keep labor and delivery open by offering a global budget that makes sure that their infrastructure costs are covered. That is section 611 of H.R. 3421, the vastly improved Medicare for All Act. Look, I know women and mothers and children are important to you. Here is your chance to act like it. Support and pass both of those. Thank you.”
RESOURCES
Healthcare Advocacy (Us)
Website
Our Newsletter resources including reproductive healthcare
Healthcare Advocacy Reading List
Find My Elected Officials
Contact the White House https://www.whitehouse.gov/contact/
Contact State and Federal Representatives
By phone: (202) 224-3121
By email: democracy.io
Important Healthcare Resources
League of Women Voters Healthcare Reform Toolkit
Organizations to Contact
National Nurses United Medicare4All
Physicians for a National Health Program
One Payer States
Healthcare Now
Reproductive Health
NARAL - Pro Choice America
Charley. chatbot abortion resource - make sure to use a secure incognito browser if you live in a state that has banned abortion
Planned Parenthood
Miscarriage and Abortion Hotline has references about where to procure abortion medications. They also assist women in the process of self managed abortion or miscarriage by phone or text and will respond in an hour. Details and hours of operation at their website.
United State of Women Reproductive health page (bottom of the page) has important resources such as medical support, access to Telehealth, prescriptions by mail, and legal support references.
Practice careful communications - The Digital Defense Fund has a number of tips to keep texts, calls, and internet use private. Here is their site.
If you need financial help with an abortion try abortionfunds.org
Claims Denials and Appeals & What to Do
Appeal a Healthcare Decision
Appeal/Negotiate a Hospital Bill
Disinformation Management
Cybersecurity Infrastructure Security Agency
Save Democracy
Chop Wood, Carry Water by Jessica Cravens
RESISTBOT
Link to the RESISTBOT site to learn more
Link to Chop Wood, Carry Water RESISTBOT write up
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