The report cites data form the state Department of Health that 23 percent of Pennsylvania’s obstetric units closed between 2004 and 2014. The trend began in urban areas, where maternity wards were closed due to hospital and health system consolidation, according to the report.
However, research cited in the report suggests these areas are not the problem. Where it is a problem — in rural areas — obstetric units have shuttered primarily due to financial and staff-related causes. The units are expensive to run, from an equipment and medical malpractice standpoint, and can be difficult to staff around the clock, according to the report. It is especially challenging in rural areas where retention can be difficult, according to data cited in the report.
Additionally, midwifery has grown significantly over the past decade in Pennsylvania. The report cites data from the Department of Health that shows there were 3,285 births outside of hospitals in 1998 and 4,551 births outside of hospitals in 2013. This contributes to the financial difficulty for hospitals trying to keep obstetric units open, but also could be a response to their lack of availability.
Lisa Davis, director of the Pennsylvania Office of Rural Health at Pennsylvania State University told the New Pittsburgh-Courier some parts of the state do not have maternity wards within a 50-mile radius, forcing women to travel far distances for appointments.
Some solutions have been proposed, according to the report. These include loan forgiveness for obstetricians who choose to work in rural areas and Medicare restructuring so that some hospitals can receive ongoing reimbursement for critical services, rather than retrospective payments for individual patients, according to the report.
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