Why Rural Hospitals in the US Are Closing Maternity Centers
2023-09-25
LRC
TXT
大字
小字
滚动
全页
1Alisha Alderson is a 45-year-old woman from rural eastern Oregon.
2In August, she was pregnant and just a few weeks from having her baby.
3But that month, the only hospital maternity center near to her closed.
4She decided to stay with her brother in the city of Boise, Idaho to be close to a hospital.
5In the United States, many rural hospitals have been closing maternity centers.
6The centers are areas of the hospital used only for mothers to give birth to their babies.
7Fewer than half of rural hospitals are now believed to have maternity units.
8That means pregnant women might have to travel long distances to have their babies under hospital supervision in specialized centers.
9The Associated Press (AP) reports that birth centers are now increasing in the U.S.
10A midwife is a person who is trained to help women give birth but who is not a doctor.
11These centers however still need a hospital nearby in case of serious problems.
12More than 2 million women of childbearing age live in places that some observers call "maternity care deserts."
13These are mainly rural areas that do not have hospitals with specialized maternity centers or obstetricians.
14An obstetrician is a doctor who specializes in the health of pregnant women.
15Some doctors and researchers say that having fewer maternity units makes having babies less safe.
16A 2019 study of information from 2007 to 2015 said that rural residents have a nine percent greater chance of facing life-threatening problems or death from pregnancy and birth "compared with urban residents."
17Dr. Eric Scott Palmer specializes in helping babies born early and newborns with high-risk complications.
18He used to serve as a doctor at Henry County Medical Center in rural Tennessee before the hospital ended obstetric care in September 2023.
19He said, "Moms have complications everywhere. Babies have complications everywhere."
20Peiyin Hung is with the University of South Carolina's Rural and Minority Health Research Center.
21She said that there are several reasons why maternity units are closing.
22Hung said there has been a decrease in the number of births in the United States.
23There are few workers in hospitals.
24And there are other reasons.
25For example, health care providers say government health insurance for the poor, called Medicaid, does not pay them enough for their services.
26The chief of Henry County Medical Center in Paris, Tennessee, John Tucker, said that closing the obstetrics, or OB, unit of the hospital was necessary to save the hospital itself.
27Tucker said that 70 percent of the births there were covered by Medicaid.
28That number is above the national average of 42 percent.
29Tennessee's Medicaid program only pays the hospital $1,700 for each baby born.
30Private insurance usually pays more.
31In the state of Oregon in 2021, the median payment to hospitals for a cesarean section, or C-section, was $16,000.
32That is five times more than what Medicaid would provide for the same operation.
33Tucker also said there were problems with having the right number of workers.
34He said when there are fewer births, hospitals lose money because their costs are fixed.
35"Whether we've got one baby on the floor or three, we still staff at the same level because you...have to be prepared for whatever comes in."
36Corina Fitch is a midwife at The Farm Midwifery Center in Summertown, Tennessee.
37It is an independent center where pregnant women can receive maternity care.
38Fitch measures women's stomachs, takes their blood, listens to fetal heartbeats, and gives nutritional information.
39These kinds of centers could be an answer to the lack of maternity care choices in rural areas.
40Many states are now taking steps to support more independent birth centers.
41In Connecticut, Governor Ned Lamont signed a law that will license these centers letting them provide care for low-risk pregnancies.
42A 2020 report from the National Academies of Sciences, Engineering, and Medicine said there is a lack of data about independent birth centers.
43It said researchers do not fully understand the relationship between birth settings and maternal death or complications.
44That is partly because there are a small number of births at independent centers.
45The Farm Midwifery Center reported that fewer than two percent of women decided to get a C-section.
46Five percent of patients were transported to hospitals in the center's first 40 years.
47Usually, women give birth at the center or at their homes.
48Fitch said, "We always have a backup plan because we know birth is unpredictable and things can come up."
49Some doctors told the AP that rural hospitals still need to be part of any answer.
50They think that state governments need to do more.
51This June in Oregon, Baker City hospital announced that it was going to close its maternity center.
52Oregon politicians got involved.
53They suggested temporarily using obstetric nurses from the US Public Health Service Commissioned Corps.
54The Corps is a group of military health care workers within the U.S. Department of Health and Human Services.
55The group usually helps with natural disasters and disease outbreaks.
56However, that did not happen.
57The public health service sent officials who advised establishing an independent birth center among other things.
58Alisha Alderson - the woman who had to go to Idaho for pregnancy care - is married to Shane Alderson.
59He said that rural communities should not have limited health care because of their size or because of the number of people on Medicaid.
60Alderson said, "That's not equitable. People can't survive like that."
61I'm Dan Novak.
62And I'm Faith Pirlo.
1Alisha Alderson is a 45-year-old woman from rural eastern Oregon. In August, she was pregnant and just a few weeks from having her baby. 2But that month, the only hospital maternity center near to her closed. She decided to stay with her brother in the city of Boise, Idaho to be close to a hospital. 3In the United States, many rural hospitals have been closing maternity centers. The centers are areas of the hospital used only for mothers to give birth to their babies. 4Fewer than half of rural hospitals are now believed to have maternity units. That means pregnant women might have to travel long distances to have their babies under hospital supervision in specialized centers. 5The Associated Press (AP) reports that birth centers are now increasing in the U.S. A midwife is a person who is trained to help women give birth but who is not a doctor. These centers however still need a hospital nearby in case of serious problems. 6More than 2 million women of childbearing age live in places that some observers call "maternity care deserts." These are mainly rural areas that do not have hospitals with specialized maternity centers or obstetricians. An obstetrician is a doctor who specializes in the health of pregnant women. 7Some doctors and researchers say that having fewer maternity units makes having babies less safe. A 2019 study of information from 2007 to 2015 said that rural residents have a nine percent greater chance of facing life-threatening problems or death from pregnancy and birth "compared with urban residents." 8Dr. Eric Scott Palmer specializes in helping babies born early and newborns with high-risk complications. He used to serve as a doctor at Henry County Medical Center in rural Tennessee before the hospital ended obstetric care in September 2023. 9He said, "Moms have complications everywhere. Babies have complications everywhere." 10Reasons for closures 11Peiyin Hung is with the University of South Carolina's Rural and Minority Health Research Center. She said that there are several reasons why maternity units are closing. 12Hung said there has been a decrease in the number of births in the United States. There are few workers in hospitals. And there are other reasons. For example, health care providers say government health insurance for the poor, called Medicaid, does not pay them enough for their services. 13The chief of Henry County Medical Center in Paris, Tennessee, John Tucker, said that closing the obstetrics, or OB, unit of the hospital was necessary to save the hospital itself. 14Tucker said that 70 percent of the births there were covered by Medicaid. That number is above the national average of 42 percent. Tennessee's Medicaid program only pays the hospital $1,700 for each baby born. 15Private insurance usually pays more. In the state of Oregon in 2021, the median payment to hospitals for a cesarean section, or C-section, was $16,000. That is five times more than what Medicaid would provide for the same operation. 16Tucker also said there were problems with having the right number of workers. He said when there are fewer births, hospitals lose money because their costs are fixed. "Whether we've got one baby on the floor or three, we still staff at the same level because you...have to be prepared for whatever comes in." 17A solution for some 18Corina Fitch is a midwife at The Farm Midwifery Center in Summertown, Tennessee. It is an independent center where pregnant women can receive maternity care. Fitch measures women's stomachs, takes their blood, listens to fetal heartbeats, and gives nutritional information. 19These kinds of centers could be an answer to the lack of maternity care choices in rural areas. Many states are now taking steps to support more independent birth centers. In Connecticut, Governor Ned Lamont signed a law that will license these centers letting them provide care for low-risk pregnancies. 20A 2020 report from the National Academies of Sciences, Engineering, and Medicine said there is a lack of data about independent birth centers. It said researchers do not fully understand the relationship between birth settings and maternal death or complications. That is partly because there are a small number of births at independent centers. 21The Farm Midwifery Center reported that fewer than two percent of women decided to get a C-section. Five percent of patients were transported to hospitals in the center's first 40 years. Usually, women give birth at the center or at their homes. 22Fitch said, "We always have a backup plan because we know birth is unpredictable and things can come up." 23Some doctors told the AP that rural hospitals still need to be part of any answer. They think that state governments need to do more. 24This June in Oregon, Baker City hospital announced that it was going to close its maternity center. Oregon politicians got involved. 25They suggested temporarily using obstetric nurses from the US Public Health Service Commissioned Corps. The Corps is a group of military health care workers within the U.S. Department of Health and Human Services. The group usually helps with natural disasters and disease outbreaks. 26However, that did not happen. The public health service sent officials who advised establishing an independent birth center among other things. 27Alisha Alderson - the woman who had to go to Idaho for pregnancy care - is married to Shane Alderson. He said that rural communities should not have limited health care because of their size or because of the number of people on Medicaid. 28Alderson said, "That's not equitable. People can't survive like that." 29I'm Dan Novak. 30And I'm Faith Pirlo. 31Claire Rush and Laura Ungar reported this story for the Associated Press. Faith Pirlo adapted it for VOA Learning English. 32____________________________________________________ 33Words in This Story 34maternity - n. relating to the time when a woman gives birth to a baby 35resident -n. a person who lives in a place, is not a visitor and legally calls the place their home 36complication - n. a problem that makes a disease or condition more dangerous or harder to treat 37insurance -n. the agreement called a policy in which the policy holder pays a company regularly so that the company will cover most of the cost of a large health, or other, expense 38income - n. money that is earned from work, investments, business, etc. 39median -n. the middle value in a group of numbers 40cesarean section - n. a surgical operation for giving birth in which a cut is made in the mother's body in order to deliver the baby (also called C-section) 41staff -n. a group of people who work for an organization or business 42license - v. to give someone official permission to do or have something 43We want to hear from you. 44Our comment policy is here.