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Maternity Care Becoming Harder for Ohioans to Access, Experts Say

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Wednesday, August 16, 2023   

By Leah Shepard / Broadcast version by Nadia Ramlagan reporting for the Kent State-Ohio News Connection Collaboration.

In Ohio, 13 of 88 counties are maternity care deserts, affecting approximately 97,000 women, according to data provided by March of Dimes. 

A county is classified as a maternity care desert if there are no hospitals providing obstetric care, no birth centers, no OB-GYN’s and no certified nurse midwives, according to March of Dimes. Bianca Zarders, maternal and infant health manager for the Cleveland Market Branch of March of Dimes, said 4,118 babies were born last year to Ohio mothers who live in maternity care deserts.

“In Ohio and on a national scale, a lot of the research shows that a lot of these women may have to drive 30, 40, 50 minutes to get to their nearest birthing hospital,” Zarders said. “And that is so problematic too, because if they’re struggling to pay for gas, or they have multiple kids who are at day care or in school, finding just the time to actually go to a prenatal appointment or to give birth and having to drive 50 minutes to get somewhere is insane.”

The dearth of maternity care in the state is getting worse, said Natasha Takyi-Micah, public policy and external affairs associate at the nonprofit Center for Community Solutions in Cleveland.

“And a few weeks ago, University Hospitals in Ashland announced that they were closing their maternity department,” Takyi-Micah said. So pretty much, that county does not have any hospitals that offer labor and delivery services unfortunately.”

The closing of the maternity department at Ashland comes eight months after University Hospitals closed their maternity department in Portage County in order to consolidate labor and delivery services at UH Geauga Medical Center in Geauga County. 

In a press release, University Hospitals said that declining birth rates and staffing shortages are both reasons for the closing the maternity department in Portage County. They said in July that the Ashland branch is closing for the same reasons. 

“The reason why a lot of hospitals are closing their labor and delivery departments or maternity wards is because of what happened during the pandemic,” Takyi-Micah said. “It seems the pandemic exacerbated many problems that came to staff shortages in the hospitals, and also there was a decline in births.”

Dr. Maria Phillis, an OB-GYN and member of the American College of Obstetricians and Gynecologists, said maternity care deserts force some patients to travel unusually far for appointments, especially if they need specialized care.

“One of our notable things we have to fill gaps for is higher-level care,” she said. “So for example, at one of the institutions that I’ve worked at, we had a patient with significantly poorly controlled diabetes who was coming essentially more than an hour and a half for high-risk appointments and wasn’t able to routinely travel that distance.”

Phillis said that many of these patients travel from very rural areas where obstetric care is unavailable.

Zarders, who works in research, policy and legislation for the March of Dimes as well as community outreach, said the lack of maternity care coupled with chronic health conditions, like diabetes, hypertension and smoking, often lead to poor childbirth outcomes and preterm births.

She said other widespread issues affect whole communities. 

“Another overarching theme is community level issues,” Zarders said. “Like socioeconomic status or environmental factors. Those also fuel the disparity when it comes to receiving adequate prenatal care, especially in communities of color.”

Zarders said that at some hospitals, women are turned away entirely because of lack of care, and that this is something that happens on a national scale.

“I recently heard a story where a woman ended up in an emergency room because she was in labor,” Zanders said. “And the nearest hospital just had an emergency room. And she was actually denied care because they didn’t have an OB person present. And so they actually asked her to go to another hospital.”

Takyi-Micah said the Center for Community Solutions is working to influence policy at the state level to alleviate this problem. 

“We just wrapped up the state budget,” she said. “We have been advocating for doulas to be reimbursed through Medicaid so more people have access to them, since they are one of the solutions to reduce the infant and maternal mortality crisis. So, that language is now included in the budget.”

This collaboration is produced in association with Media in the Public Interest and funded in part by the George Gund Foundation.

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