Inside Texas' maternity deserts: 5 things to know

With only 40 percent of rural hospitals in Texas offering labor and delivery services, "maternity deserts" across the state are growing as staff shortages shutter rural labor and delivery units, according to a Jan. 20 report from The Texas Tribune.

Five things to know:

1. Patients are increasingly giving birth in the emergency room as rural hospitals limit or cut labor and delivery services. Texas leads the U.S. with most rural hospital closings, and two-thirds of the state's remaining 157 rural hospitals are public, meaning less flexibility for salary negotiation. As surviving hospitals cut back services, labor and delivery is often first to go.

2. Amid critical staffing shortages and COVID-19 surges, Hereford Regional Medical Center has days where it diverts labor and delivery patients to Amarillo — 50 miles away — because there aren't enough nurses to operate the unit, the hospital's CEO told the Tribune.

3. Adrian Billings, MD, family medicine and obstetrics physician, has been at Alpine-based Big Bend Regional Medical Center for 15 years and said pregnant patients sometimes drive over 100 miles to give birth there. Recently, for the first time since Dr. Billings started working there, the hospital has limited the hours the labor and delivery unit is open, at times only open Monday through Thursday morning.

"When that happens, essentially, it's a maternity care desert Thursday morning through Monday morning out here," Dr. Billings told the Tribune. 

Big Bend Regional Medical Center recently hired more nurses and will soon be able to resume full-time maternity care, a spokesperson said in an email to the Tribune.  

4. Sweetwater-based Rolling Plains Memorial Hospital typically tries to have three labor and delivery nurses on per shift. But recently, the team has only had one nurse and a shift supervisor, said Jennifer Liedtke, director of the labor and delivery unit. She said it is particularly challenging to recruit for a rural hospital because one nurse must handle all roles across labor and delivery, the nursery and postpartum care. For a while, she feared the unit may have to shut down because of the federal vaccine mandate for healthcare workers recently upheld by the Supreme Court.

"To be very clear, I would love to see everyone vaccinated," she said. "But from a staffing perspective, we were probably going to lose half of our [obstetrics] nurses."

5. John Henderson, president and CEO of the Texas Organization of Rural and Community Hospitals, said he fears short-term closures will create a ripple effect.

"You've compounded the problem by forcing people to leave the community when they need care," he told the Tribune.


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