Saturday, March 3, 2018

Bad news for rural mothers

Since I was in college, I've heard bad things about our local hospital, Warren Memorial Hospital (WMC).  It was understaffed, it took forever to be seen, the ER waiting room was always full.  When John was hospitalized there years ago for diverticulitis, it took hours for him to get any pain meds and he was kept without food for half a day longer than he needed to be, because that's how long it took to see a doctor.

But the doctors and nurses there didn't seem to be incompetent, just too few.  And in recent years, I have been hearing it's been a lot better.  It might be Obamacare--forced and subsidized insurance means they're not carrying the burden of all the uninsured people in the county, as they previously did.  Or it might be that the hospital was bought out by Valley Health, a big hospital group.  The town has started to be spotted with Valley Health signs: my doctor, the kids' doctor, the lab, the nursing home, the urgent care.  Everything's owned by Valley Health.  But they do a good job, so far as I know, so I haven't been making a big fuss about the monopoly.

It turns out I should have been.  Lately the government put in a big, beautiful road which goes around town and makes it a lot easier for people in certain neighborhoods to get to the freeway.  And on that road, Valley Health is building a new hospital.  The plan is to close WMH, which is admittedly old, and build something much nicer.  So far, so good.  But they're not building a labor and delivery unit.  No ob/gyn services will be offered at the new hospital.  The staff of the women's care wing are getting laid off, and women with delivery dates after June are being told to change their plans to deliver at the next closest hospital, Winchester Medical Center (WMC), half an hour away.

Half an hour isn't that far.  But, of course, it's further from some parts of the county.  And even half an hour is a long time to ride in a car when you're in labor.  I'm a person who has had very fast labors, so I wouldn't have wanted to deliver somewhere so far from where I live.  And what if it were in rush hour?  It's taken me an hour to traverse the same distance once, when there was a traffic jam.  I don't know about you, but I wouldn't be keen to deliver on the side of I-81.

Of course, I have homebirths.  But I had homebirths in part because I knew we were very close to a hospital and could have been there in five or ten minutes in an emergency.  I didn't have a homebirth because I wanted medical help to be unavailable; I had one because I wanted to stay in the safety of home so long as there weren't any worrisome warning signs.  There weren't, and I never went in .... but imagine my midwives trying to transport a laboring woman for 35 minutes, while the baby is in distress or the mother is bleeding.  That is much, much too long.  Women aren't going to want to sign up for a homebirth if there's no closer care than that.

And then there's the question of prenatal care.  Not everyone in town has cars, but the bus only goes around town.  It doesn't go to Winchester.  You can take a cab, but round-trip cab fare to WMC runs about $70.  A lot of people here can't spare $70 a month, on top of the doctor bill, to get checkups.  That means warning signs like high blood pressure will be missed.  High blood pressure, leading to pre-eclampsia, is one of the leading causes of maternal mortality.  That's why women who don't have access to prenatal care are much more likely to die.

That's really what this comes down to: women and babies dying.  Rural women are 60% more likely to die in labor, and lack of access to ob/gyn care may be why.

WMH has been delivering about 375-400 babies a year in recent years.  That's not a lot -- way less than WMC -- but it's been enough to have an L&D unit all this time.  So why isn't Valley Health keeping it now?

The answer is that Valley Health also owns WMC.  They're not losing any business by this move, because there's no hospital closer than WMC for people to go to.  They want to save money on building a new L&D ward by diverting all those people to WMC.  Yes, it is likely to raise maternal and infant mortality in our county.  But!  It helps their bottom line, so what else do we expect?

Our struggle here is echoed around the country.  Hospitals are closing L&D wards in rural areas, to the detriment of maternal and infant health.

Right now women in the area are protesting the decision, hoping it's not too late to save maternity care in the county.  They've got a facebook group and had a protest.  There's a bigger rally coming up soon -- March 17th, at the gazebo.  I just don't know that Valley Health is going to listen to us.  Most of our elected representatives seem to be on our side, but the hospital is privately owned -- it doesn't have to keep an L&D unit open if it doesn't want to.  I just hope the bad publicity and the weight on their consciences will do the trick.

1 comment:

Anonymous said...

You should submit this to your local paper as an op ed. More awareness is needed.

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