UVMC among a dozen Ohio hospitals to close or consolidate a maternity unit since 2022

“It was our inability to recruit providers, so we’ve been spending approximately the last 18 months trying to recruit physicians to Upper Valley Medical Center, and we have not been successful,” said Kevin Harlan, president of UVMC and Atrium Medical Center.

Prior to the decision to close the labor and delivery unit, UVMC was utilizing locum tenens physicians, or agency physicians who fill in on a temporary basis, he said. The use of fill-in doctors, though, did not provide many mothers with knowledge of who would be delivering their babies.

“When you have agency physicians in there, you cannot guarantee that consistency to the expectant mom, and oftentimes that is why they choose a different location because they want to know who the provider is going to be that’s going to be caring for them pre- and post-natal and certainly at the time of delivery,” Harlan said.

In addition to difficult finding providers, more pregnant patients already travel outside of the county to give birth compared to those that stay within Miami County, the hospital system said.

Greater than 50% of pregnant people already choose to give birth in Montgomery County, most at Miami Valley Hospital, Harlan said.

The number of babies born at UVMC in 2023 was half of what that number was a decade ago, according to the hospital, which said there were approximately 325 births at UVMC in 2023.

Changing patient demographics for south campus

These factors were different from the closure of Miami Valley Hospital South’s labor and delivery unit closing in June 2022 as Premier Health was deciding how to best accommodate patients of an older demographic and their needs.

“In the three plus years prior to the decision for (Miami Valley Hospital) South consolidating with main campus, we saw a change in the patient demographic demand for that south campus,” said Melissa Merritt, vice president over women’s services service lines at Premier Health.

Patients at Miami Valley Hospital South, through its emergency department and surgery volumes, were middle-to-late older adults, she said.

“We were running out of space to accommodate those emergency room admissions and then being able to vet them after surgery timely,” Merritt said. “We really needed to look at that campus footprint and figure out how to take care of the surge and demand.”

Financial pressure from the COVID-19 pandemic has also forced hospitals to make difficult decisions, the Greater Dayton Area Hospital Association said.

“GDAHA members are not immune to these financial pressures and weigh them carefully as they seek to ensure equitable access to care across the Dayton region,” said Sarah Hackenbracht, GDAHA’s president and CEO.

Rising staffing costs, shortages in clinical specialties, and escalating drug and medical supply prices are operational factors that must be considered in 2024, she said.

A growing trend in closures

Premier Health has not been alone in deciding to pull back on offering labor and delivery services as there has been a growing trend in hospitals and health systems in the state to either close or consolidate their maternity unites.

Since 2022, there have been 13 hospitals in Ohio that have closed or consolidated maternity units, according to the Ohio Hospital Association.

It’s a challenge to recruit just about any specialty anymore, Harlan said, but OBGYNs have been difficult to recruit for this region.

“I think we’re just in this unique spot for Upper Valley Medical Center where it’s been exceedingly challenging for maternity services, for obstetricians. I do know it’s a challenge across the country. It’s a challenge across the state,” Harlan said.

Other counties in the regions, including Darke, Shelby, Auglaize, and Mercer counties, have also had a challenging time recruiting OBGYNs, he said.

Infant, maternal health

These closures and reductions in available hospital-based resources for growing families have some policy experts concerned about the impact this will have on infant and maternal health in the future.

The closures and consolidations of maternity services across the state is disproportionately affecting women who have Medicaid, said Brandy Davis, a Medicaid policy expert at the Center for Community Solutions, a think tank in Cleveland.

“They’re more likely to live in a rural area where those hospitals and access to maternity care may have been further away to begin with,” Davis said.

For areas that have lost maternity wards, Davis said they are seeing longer travel times, longer wait times, and harder time getting in to see doctors.

“We’re seeing that with closures, women are having to drive further. They’re having to wait longer for certain onboarding appointments,” Davis said.

Premier Health will still be maintaining an obstetrical practice in Miami County, which will give them time to address transportation issues to Miami Valley Hospital, Harlan said. Premier Health will also be opening a women’s imaging center in Miami County later this year.

Premier Health believes it will be able absorb additional patients at its main campus in Dayton, opening up additional unused space in its Berry Women’s Health Pavilion and Family Health Center, Merritt said.

Region-wide help for mothers

“The closure of labor and delivery units is a challenging decision for any hospital and the communities they serve,” Hackenbracht said.

Maternal and infant health depends on more factors than care inside hospitals, Hackenbracht said.

“GDAHA members recognize that some of the most impactful investments in maternal and infant health occur upstream with high quality prenatal care readily available in our communities, safe and affordable housing for mothers, and access to healthy, nourishing foods in our neighborhoods,” Hackenbracht said.

Hospitals in the Dayton region have engaged with GDAHA’s programming aimed at supporting local families, such as Help Me Grow Brighter Futures, the Dayton Regional Pathways HUB, and Healthy Beginnings at Home, she said.

“These programmatic investments, in partnership with local county and state agencies, build the foundation to ensure mothers and their babies can achieve optimal health and wellness,” Hackenbracht said.

Ohio hospitals that have closed or consolidated maternity wards