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High costs, demographic changes force birthing services to end
By KATE JACKSON
Laboring women in Cook County soon will need to drive more than 100 miles to reach a hospital in which to give birth. Beginning in July 2015, the Cook County North Shore Hospital (CCNSH) in Grand Marais will no longer offer scheduled deliveries. This decision comes as a result of the hospital board voting unanimously on Jan. 30 to discontinue elective obstetrics services at the facility. Once the change goes into effect, the only births that will be accommodated at the hospital will be those considered an emergency.
In August of 2014, Coverys, the Medical Professional Liability insurance company for CCNSH, conducted an analysis of the facility’s obstetric care services. The hospital board received a report last October and found Coverys raised several concerns regarding the hospital’s ability to provide obstetric care in a manner consistent with professional standards set forth by organizations such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. The board concluded that, without making the recommended improvements, the hospital’s insurability would be jeopardized. They emphasized the motivation behind the change in a collective statement.
“Our nurses and the medical providers have done an excellent job of providing quality obstetrical care through the years, but the question before us is not whether we provide good care but whether we can meet the standards of care for obstetric services,” it said.
For the last decade, the hospital has been delivering an average of about 10 babies per year, which equals only 20 percent of all births by Cook County residents. The decision to discontinue scheduled deliveries was a result of the hospital’s inability to continue meeting the standards of care associated with birth in a hospital setting. Specifically, it involves the facility’s lack of on-site surgical services or the ability to provide an emergency Cesarean section to patients within 30 minutes of the hospital. The cost of offering that necessary option to patients, including adding an operating room, is estimated to exceed $1 million per year, a cost that’s beyond current resources.
According to the Minnesota Hospital Association, the discontinuation of scheduled delivery services in rural Minnesota hospitals is becoming a very real trend. CCNSH will end its obstetrics services on the same date as another nearby rural medical center, the Ely-Bloomenson Community Hospital. Other small hospitals in Greater Minnesota at Wheaton, Springfield, Appleton and Baudette have also decided to discontinue their elective delivery services in recent years.
A recent report by the Minnesota Department of Health’s Rural Health Advisory Committee concludes that rural Minnesota is trending toward a loss of obstetric care, stating, “There is a general decline in the number of family medicine physicians including obstetrics in their practice and a general decline in the number of rural hospitals offering obstetrical services.” Factors contributing to the reduction in services include aging populations in rural communities, obstetric workforce shortages and costs to implement technology or update facilities to maintain obstetric services.
“It was not a question of whether we wanted to provide elective OB services, but one of whether we can provide elective OB services safely and in a manner that meets the standards of care. The board, in consultation with the medical staff, made the decision we believe is in the best interest of patients, the hospital and the community,” CCNSH board chair Kay Olsen said in a press release.
The decision to discontinue this important service, however, has some residents of Grand Marais and the surrounding area very concerned, with the long and often hazardous drive to the nearest birthing facilities in Duluth topping the list of worries. Cook County resident Kristin Wharton stood up in defense of maintaining local birth options for families, starting a Facebook page to keeping birth as part of the community. She and others who support birth options in Cook County had hoped to work with the hospital board to find another solution. After the decision was made final, Wharton shared her thoughts on Facebook, saying that rural residents are becoming an endangered species.
“Somehow, our health care needs are less important than people in the metro and our leaders wash their hands because ‘it’s a business decision,’” Wharton wrote, adding, “I’m deeply sad for this loss and all the known and unknown ways it will change our lives and our community.”
In response to the Facebook campaign, CCNSH board member Tom Spence said, “We appreciated and valued the community conversations through this process. We are committed to working with community members to ensure the best possible transition to this new model.”
Officials of the Sawtooth Mountain Clinic in Grand Marais said they remain committed to providing prenatal and postnatal care to women in Cook County, planning to possibly expand their services to accommodate new needs that may arise. At a recent meeting, residents shared ideas on how to combat the problems resulting from this loss of service, demonstrating that the community is continuing to band together in support of women and families who may be affected by the change.Previous BusinessNorth Exclusives Articles:
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