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Spritzler Maternity Health closes it's doors.

A dejected Spritz sat in a pool of his own tears during a press conference. "Nobody wants to get pregnant or deliver babies anymore. I realize they're a royal pain in the ass but that never stopped anyone before."

"Maybe I'll open a dog shelter. People seem to like canines."

Hospitals Shutter Maternity Wards Amid Falling Birthrates

Women have fewer delivery options in rural, aging parts of the U.S.

By Melanie Evans, WSJ

Aug. 10, 2023 8:00 am ET

More hospitals are getting out of the baby business.

Last month, Ohio-based University Hospitals said it would halt maternity services in the city of Ashland. OSF HealthCare said its hospital in Pontiac, Ill., would do so in September. Trinity Health plans to stop delivering babies in Troy, N.Y., and Baker City, Ore.

Megan Nelson, an emergency-room nurse for Trinity Health’s St. Alphonsus Medical Center in Baker City, has never delivered a baby. She will soon be responsible for women who arrive in labor and can’t get to the nearest hospital with maternity services, a 45-minute drive away.

“It’s a scary prospect,” said Nelson, a member of the Oregon Nurses Association.

The closures are broadening a swath of America without maternity units, commonly communities that are sparsely populated or aging. The trend threatens to worsen infant health and maternal death rates that have hit the highest level in decades.

Hospitals that are closing maternity units said they can’t recruit enough staff to safely operate. Hospitals with fewer births are less attractive to doctors and nurses, executives said. Births at OSF HealthCare St. James-John W. Albrecht Medical Center in Illinois declined to 120 last year from 184 in 2019.

“There’s just not enough babies to be had,” said Dr. Michael Cruz, OSF HealthCare’s chief operating officer.

Roughly 2.2 million women of childbearing age lived in so-called maternity deserts in 2020, according to March of Dimes, which it defined as counties without a hospital, a birth center, and doctors and nurse midwives with experience delivering babies. The 1,052 counties on the list represented an increase of 70 counties since 2016, the nonprofit’s latest analysis found.

The prices hospitals negotiate with health insurance companies are a major driver of high U.S. medical costs. WSJ analyzes the rates at one hospital to explain why the prices for the same surgery, at the same hospital, can vary so widely. Illustration: Ryan Trefes

Women in remote rural communities are more likely to give birth too early after losing a local maternity unit, research shows. Babies born preterm are at higher risk of death, disabilities or chronic health issues, such as asthma. Women who give birth in rural hospitals that deliver fewer babies are also at higher risk for serious complications, such as acute kidney failure, research shows.

Investments to improve safety in low-volume hospitals could mitigate the risks, said Katy Kozhimannil, a University of Minnesota professor who studies maternal care and hospital-unit closures. “It’s better to have a facility to give birth at than not to have anything at all,” she said.

Trinity’s hospital in Stafford Springs, Conn., tried training its own labor and delivery nurses only to have them leave for other hospitals, hospital testimony to state regulators said. Trinity has sought permission from Connecticut regulators to close the maternity ward in Stafford Springs.

Trinity’s maternity unit at Samaritan Hospital in Troy, N.Y., lost $2.3 million last fiscal year, and some women were transferred to other hospitals to give birth because of nurse staffing shortages.

The nonprofit delayed closing maternity services at St. Alphonsus Medical Center in Baker City until this month after public outcry. St. Alphonsus has plugged nurse vacancies at the Baker City hospital with temporary staff but can’t find permanent replacements with a dwindling number of deliveries, said Gay Landstrom, Trinity’s chief nurse executive.

“It becomes very hard to retain them and next to impossible to recruit,” Landstrom said.

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