As Pennsylvania's Rural Delivery Rooms Close, Women Face No Choice But To Travel For Care
Courtney Bittner is mom to 3-year-old Bentley, and 3-week-old Nash.
She was ecstatic about her first pregnancy, and immediately went to Somerset OB/GYN right next to Somerset Hospital. Both are located about 15 miles from her home in Somerset County, southeast of Pittsburgh.
For the most part, it was a healthy pregnancy, and on the Fourth of July 2014 her water broke, and her husband rushed her to the hospital.
“It wasn’t really wasn’t bad or anything to drive there,” she said. “We went in, they took us straight up, and we pretty much had him right away, because my labor progressed really quickly with him.”
All ended well, but because of complications, Bittner had a cesarean section. She’d developed preeclampsia, or really high blood pressure, which can be fatal for moms.
A few years later, she was shocked to discover she was pregnant again.
But then came another shock; Somerset Hospital had closed its delivery room the year before. While pregnancy can be an emotional and difficult time for many women, Bittner came to know a challenge facing many mothers in rural areas. She could still go there for prenatal care, but she’d have to deliver her next baby at Conemaugh Valley Memorial Hospital in Johnstown, about 30 miles away.
“It was traumatic,” she said.
She was terrified at the thought of another quick delivery.
“I was like, my water’s going to break and this baby’s going to start coming out immediately, and I’m going to have to drive the whole way to Conemaugh, and it’s all back roads, and windy, and no cell phone service half way there,” Bittner said. “I’m not going to be able to call anybody. Brandon’s going to have to deliver the baby in the car.”
That’s less of a concern for women within 15 miles of Pittsburgh, where there are at least half a dozen delivery room options, not to mention the state’s largest neonatal intensive care unit at Magee-Women’s Hospital of UPMC.
Bittner has no complaints about the service she received in Conemaugh, but because she had complications throughout her second pregnancy, she had to make many long trips.
“I would go over to Somerset and they’d say, ‘oh we have to send you to the hospital,’ and I’m like ‘are you kidding me? I have to run the whole way back down to Johnstown?’”
Jerry Murry, President of UPMC Altoona and UPMC Bedford, said this is the reality in lots of rural areas. “There’s just such a shortage of resources,” he said.
Murry said Bedford doesn’t have enough physicians, nurses, or equipment to sustain its delivery room, so UPMC Bedford is joining the list of hospitals closing their delivery rooms. As of Dec. 1, patients will be directed to Altoona – 40 minutes away.
Compared to Magee-Women’s Hospital of UPMC’s 11,000 annual births, Bedford delivers about 300 babies a year, which means they only have a few obstetricians.
“So we had to make a decision, partly being more proactive, being concerned that if we were to lose one or both of those physicians, we would be in a crisis mode,” said Murry.
It’s difficult to get the doctors who deliver babies to go to rural areas because they’re on rotation with so few doctors, for an emergency procedure that could happen any time. Plus, Murry points out that complications can arise when a doctor isn’t practicing a procedure very often. “It’s the right thing to do for the patients for a quality perspective,” he said.
The more deliveries that can be aggregated in one location, the more doctors a hospital has on rotation, and the easier it is to recruit.
About a dozen delivery rooms in Western Pennsylvania have closed since 2000, including Jameson Hospital in New Castle, and Ellwood City Hospital. And Murry thinks this trend of regionalization is likely to continue because the population in Pennsylvania is aging and the birth rate is declining.
To prepare for Bedford’s consolidation, UPMC is working to train emergency staff and ambulance companies.
“We will also be talking with patients in the office, assessing their ability to travel, do they have transportation, do we need to provide something, there would be gas cards given to patients if getting to Altoona was a struggle,” said Murry.
Mom Courtney Bittner said switching delivery rooms took her out of her comfort zone, but she did see some benefits, like going to a facility with better emergency care, including a NICU.
“So that was like a huge plus,” she said, “if anything was potentially wrong, you have that to back up on, so it wasn’t as nerve-wracking I guess as it could have been.
Bittner said she understands the tradeoff, but for many mothers – they won’t have a choice but to travel for care.
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