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Published by , Thursday, January 15th 2015

And Women's Lives Are On The Line

canada goose black friday sale Snow was piling up outside her house in the mountains of rural Spruce Pine, North Carolina, but the contractions were mild, and she was a week shy of her due date, so she assumed it was simply canada goose black friday sale false labor. canada goose coats on sale Kerr called her doctor, drank a glass of water and tried to relax. Her husband raced around the house, throwing everything the couple needed for the hospital into his dirty work truck, and they began the six mile canada goose descent to the hospital on winding roads covered in 5 inches of snow. canada goose black friday sale

Kerr did her best to breathe through the contractions that crashed down upon her, trying not to canada goose store fixate on the two occasions they'd spun off the very same roads in similar whiteout conditions.

Because of the snowstorm, Kerr's regular physician did not arrive at the hospital in canadian goose jacket time to help her deliver. Instead, she gave birth under the guidance of the labor and delivery nurses who coached her through pushing being mindful of the fact that the baby's heart rate was dropping while an emergency room doctor caught the newborn. Less than an hour Canada Goose sale after they arrived at the hospital, Kerr held a healthy baby girl in her arms.

Canada Goose online If the drive had been even a few minutes longer, she is certain, she would have delivered her daughter on the side of a snowy, low visibility road. Canada Goose online

And if Kerr were giving birth this winter, the trip to the hospital would be significantly longer. The Spruce Pine labor and delivery unit will close at the end of September, the latest in a string of maternity ward closures that leave expectant mothers in the mountains of western North Carolina without access to Canada Goose online maternal care within reasonable distances of their homes.

"It was such a reassuring experience to be able to deliver in our local hospital, and receive great care and be able to be close to home," she said."I don't know what would have happened to me or our daughter had we had to drive [elsewhere]."

canada goose Mission Health, a nonprofit hospital network headquartered in Asheville, North Carolina, has operated many longstanding small hospitals throughout Asheville's 19 county region most notably in rural, low population areas like Spruce Pine and Marion, which are north of the city, and Brevard, Franklin and Highlands to the south. canada goose

Until two years ago, each of these communities had a labor and delivery center nearby. But in 2015, Mission began to close them. First, it was a unit at the Transylvania Regional Hospital in Brevard, servicing nearly 33,000 residents. Then in July 2017, Mission shuttered labor and delivery at Angel Medical Center in Franklin, affecting about 40,000 people in Macon County and surrounding counties. At the end of September, Blue Ridge Regional Hospital of Spruce Pine will also lose its labor and delivery unit, affecting the 33,000 people in Mitchell and Yancey counties who rely on that hospital.

Canada Goose Online At that buy canada goose jacket point, Mission will provide birthing services only at its locations in Asheville and Marion. That means women in rural counties will have to drive at least 20 miles to give birth and if they want to be able to see the same providers in the delivery room they saw throughout their pregnancies to get prenatal care. Canada Goose Online

The roads through the mountains during labor pose a major concern, even without snow. The peaks in this region are the highest in the eastern canada goose deals United States. Except for a few major highways, such as Interstate 40, most roads weren't built by blasting through or tunneling under these hills. They wind around them, often with precipitous drops on one side.

It is an issue facing rural communities nationwide: From 2004 to 2014, 9 percent of canada goose clearance all rural counties lost access to hospital obstetric services, and more than half of all rural counties in this country are now without a single local hospital where women can get prenatal care and deliver babies.

canadian goose jacket It is logistically challenging and expensive to staff a unit that must be ready for women day and night, and it is difficult to make enough money when there simply aren't enough women coming in. Nationally, more than half of births are funded by Medicaid, which pays doctors back at a much lower rate than private health insurance plans. In rural areas, that percentage tends to be even higher. Malpractice insurance also plays a role. Family physicians, who often deliver babies in rural areas, face higher malpractice premiums if they offer obstetric services, while hospitals may face low volume penalties. canadian goose jacket

"Hospitals that have the fewest births have to pay the highest premiums, because the risk level is higher when something happens less frequently," said Katy Kozhimannil, a professor of health policy and management at the University of Minnesota, whose research focuses on the challenges in rural obstetric health care access. "This is all from conversations with folks. it's not something we've looked at in research, but it is something that comes up in conversation with clinicians, and with hospitals."

Canada Goose Jackets All of which means that delivering babies is a money loser for small hospitals already struggling to stay afloat. Canada Goose Jackets

canada goose coats on sale Aside from the substantial inconvenience of significant travel to medical providers, these closures have rural residents concerned that they'll be put in dangerous situations, including giving birth on the side of the road, at home or with lesser qualified emergency providers. canada goose coats on sale

"We cannot ignore the fact that when a health care system or a hospital decides that it's no longer worth the risk to keep the obstetric unit open, that risk does not go away," said Kozhimannil. "It migrates from the hospital to the homes of the people living in that community."

canada goose factory sale The stakes for expectant mothers are high. The United States has the worst rate of maternal deaths in the developed world, and that rate is rising. Women living in rural areas tend to fare worse for reasons that aren't yet entirely understood, though http://www.canadagoosecanadaoutlet.com underlying health problems and limited access to high quality prenatal care are thought to play a crucial role. canada goose factory sale

uk canada goose outlet The battle to keep maternity wards open uk canada goose outlet

canada goose store For its part, Mission blames the cuts on low demand and financial losses at these locations. Deciding to close these labor and delivery services was "incredibly difficult," Mission Health spokeswoman Rowena Buffett Timms told Carolina Public Press. But she said it stemmed from the company's "responsibility to ensure that we have the region's best interests in mind." canada goose store

canada goose clearance sale For Mission, the decision came down to financial sustainability and the ability to continue providing other forms of care amid what Timms described as "the abject chaos in health care policy in our nation." canada goose clearance sale

uk canada goose Nationally, it's not just labor and delivery that is being slashed; entire hospitals are disappearing. States in the South and those that did not choose to expand Medicaid under the Affordable Care Act have been particularly hard hit. In addition to the challenges that have long plagued rural hospitals difficulty recruiting and retaining staff, deteriorating facilities they have been hit by Obamacare era cuts to a program that reimbursed hospitals for bad debt without any of the financial boost the health care overhaul offered states that expanded Medicaid. uk canada goose

At Angel Medical Center in Franklin, Timms said the company was unable to continue sustaining losses of up to $2 million annually on the labor and delivery program as it prepared to invest in a badly needed $43 million new hospital. The company estimates that not including a labor and delivery center in the new facility will cut $7 million in cost.

canada goose uk outlet "We have shared previously that there has been no growth in newborn deliveries in the region and there is no growth forecast," Timms said of Angel. canada goose uk outlet

Timms described Spruce Pine as having the third lowest volume of births of any facility in the state, so low that she claims it was difficult for the staff to "maintain proficiency."

Not only were these counties more sparsely populated, but mothers "voted with their feet," according to Timms, by traveling to Asheville to give birth. Dorothy DeGuzman, a family physician with a specialty in high risk obstetrics who has admitting Canada Goose Outlet privileges at Blue Ridge Regional Hospital in Spruce Pine says she sees that in her own patients. Some simply feel more comfortable delivering at a larger hospital with a neonatal intensive care unit.

"There are women who drive to Asheville when they don't have to necessarily, and there also are women who are too high risk for us," she said. "For example, someone who had complicated twins should go to Asheville. Someone who comes in in pre term labor, they go to Asheville. We deliver babies at 35 weeks and up. We do transfer when it's clinically appropriate."

canada goose uk black friday This has also factored into a decision to include a maternity unit in the plans for an upgraded Mission facility in Marion, slated to open in 2018. buy canada goose jacket cheap Timms described this consolidation as "the only responsible decision." canada goose uk black friday

buy canada goose jacket cheap And the activity of other hospitals in the region contradicts this rationale while canada goose coats national trends reflect Mission's reasoning, other local companies are increasing their investment in maternity care. Eight small community hospitals in Murphy, Hendersonville, Sylva, Clyde, Morganton, Rutherfordton, Columbus and Boone operate labor and delivery services, and none has cut back on birthing services Canada Goose Parka during the time Mission Health has been making cutbacks. In fact, several describe increasing demand for their maternity units and a philosophy in which canada goose outlet cheap Canada Goose labor and delivery services are integral to their work buy canada goose jacket cheap.

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