Bosses at hospitals in rural areas are shuttering maternity wards, claiming it’s no longer profitable to maintain them. This throws into disarray the health and lives of millions of women, their families and their newborn babies.
The employers’ actions come as maternal deaths rise here at a higher rate than in any other industrialized country, more than one death for every 5,000 live deliveries. More women are also developing life-threatening complications. These conditions fall overwhelmingly on working-class women.
A third of all counties in the U.S. are considered “maternity care deserts,” according to an October report by the March of Dimes, without obstetric care, birth centers, obstetrician-gynecologists and certified nurse midwives. Almost 7 million women of childbearing age reside in these counties.
Fewer than half of women in rural areas can find prenatal care within 30 miles, according to the Centers for Medicare and Medicaid Services.
“Three days before Christmas, the only hospital in this remote city on the Yakima Indian Reservation abruptly closed its maternity unit without consulting the community, the doctors who delivered babies there or even its own board,” reported a New York Times article from Toppenish, Washington.
At least 35 women were scheduled to give birth at Astria Toppenish Hospital there in January, and the closure created a crisis for many soon-to-be mothers. Ambulance services are unreliable and sparse, with long waits and vast distances to travel to get to another hospital.
After acquiring the hospital, company owners at Astria had said they would keep maternity services available for at least a decade. Now they say they can’t afford to. “There will be lives lost — people need to know that,” Leslie Swan, a doula, who helps pregnant women and their families at the time of birth, told the Times.
By 2020, one-half of all rural community hospitals did not provide obstetrics care, the American Hospital Association said. And this trend has accelerated over the past years “as hospitals from Maine to California have jettisoned maternity units, mostly in rural areas,” reported the Times.
Women living in rural areas are three times as likely to die during pregnancy and the critical year afterward than those living closer to hospitals that provide care, said a study of mothers in Louisiana.
Shantel Jones called the Windham Community Memorial Hospital in Connecticut, a few blocks from where she lived, when she went into labor in 2020. But the hospital told the ambulance driver they had closed the maternity unit and to take Jones to Norwich, a 30-minute drive away. They didn’t make it. She gave birth on the roadside. The Norwich hospital was then unable to give the baby boy the intensive care he required and they embarked on a further 30-minute trip to a hospital in Hartford. Mother and baby are fine now.
“I didn’t know what was going to happen,” Shantel’s mother, Michelle Jones, told Vox Media. “When you have a city full of women who have to have babies, how are you going to do that?”
Hospital bosses’ decision to protect profits at the expense of women’s lives underlines the fact that there is no road to women’s emancipation “separate and apart from the working-class struggle to confront the crises bearing down on working people and our families,” as Socialist Workers Party leaders Jack Barnes, Mary-Alice Waters and Steve Clark write in the new book The Low Point of Labor Resistance Is Behind Us: The Socialist Workers Party Looks Forward. “That, in turn, requires a class-struggle course to address the challenges and responsibilities that fall overwhelmingly on women as the bearers and nurturers of new life.”
In addition to closing pregnancy services, increasing numbers of rural hospitals are shutting down entirely. More than 179 rural hospitals nationwide closed between 2005 and 2020.