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By Liora Engel-Smith

An Eastern North Carolina hospital that stopped offering labor and delivery services earlier this year will no longer offer gynecological services for lack of staff.

Martin General Hospital discontinued its maternity services at the end of October and said at the time that it would continue offering gynecological services at the hospital and in its clinic, Roanoke Women’s Healthcare. But the hospital’s two obstetricians found other jobs, leaving the hospital without physicians who can offer gynecological care, hospital spokeswoman Heather Wilkerson confirmed.

Martin General Hospital announced earlier this year that it was stopping its maternity services. Image courtesy of Martin General Hospital.

Interim CEO John Jacobson said in November that the hospital was exploring options for the Roanoke clinic.

“As always, we remain focused on meeting the needs of the community and are honored to provide local access to care here in Williamston,” he said in a Nov. 27 email statement.

But on Thursday morning, Wilkerson said the hospital will close the clinic effective Jan. 3.

“While this is not the outcome we desired, patients are already choosing to receive women’s health services at other facilities,” Wilkerson wrote said in her email.

The hospital will help women transition their medical records elsewhere, she added.

Martin General cited declining birth rates in its decision to discontinue maternity services and said that three other birth centers within a 35-mile radius could accommodate the region’s pregnant women.

One of these facilities — Vidant Beaufort in Washington, a town roughly 20 miles south of Williamston — is already making plans to open a satellite obstetrics and gynecology clinic in Martin County.

“Vidant’s goal is to keep care as close to home as possible,” said Vidant Health spokesman Jason Lowry. “We are actively working to open an outreach clinic in Williamston. The clinic will provide obstetrics and gynecology services for patients in Martin County and will be an extension of our labor and delivery services at Vidant Beaufort Hospital.”

Lowry said he did not have a timeline for the clinic’s opening but said it will be sometime in 2020.

Filling a gap, but not entirely

Martin General isn’t alone in discontinuing its labor and delivery services. Since 2017, at least five other rural hospitals across the state have taken similar measures even as the nation grapples with rising maternal and child death rates. 

Research shows that inadequate prenatal care is associated with poorer health outcomes and higher maternal and child deaths.

Rural hospitals with maternity and neonatal services are green. Rural hospitals that have either discontinued or will discontinue their maternity services are red. Urban hospitals are blue. Chatham Hospital, which has plans to open a maternity ward in 2020, is purple.

Note: This map has been updated thanks to feedback from our readers on an additional labor and delivery unit closure.

This map collates N.C. hospitals which had 25 or more deliveries in FY2017. We updated names of hospitals that have since changed, with the old name in parentheses. The data come from the North Carolina Healthcare Association, which surveyed hospitals for the information. When hospitals didn’t respond to the survey, fields remained blank.

Urban/rural designations are based on definitions from the Centers for Medicare and Medicaid Services.

The American College of Obstetricians and Gynecologists define OB level 1 as basic care, OB level 2 as specialty care, and OB level 3 as subspecialty care.

Data source: N.C. Healthcare Association. Map credit: Liora Engel-Smith

These closures are often driven by the hospital’s bottom line, since staffing a unit with obstetricians around the clock is expensive. But for rural women living in these communities, the absence of nearby maternity services means longer travel times, often at a higher cost, and an increased rate of medical complications.

Vickey Manning, a social work supervisor at the Martin-Tyrrell-Washington District Health Department, said Vidant’s decision to open a satellite clinic in Martin County is a welcome development.

“We were very excited when we heard they were interested in opening up a clinic here in Martin County,” she said. “Even though women won’t be able to deliver here in Martin County at least there is another option for women as far as prenatal providers closer to home.”

Though the health department offers prenatal care, Manning said previously that many women prefer to get care from the doctor who will eventually deliver their babies, an option that the health department cannot offer.

A letter sent to patients announcing that an obstetrician is leaving Martin General Hospital effective January 3. Another physician left the hospital earlier this year around the time it stopped offering maternity services. Photo credit: Stephanie Howell.

In addition to prenatal care, the health department also offers gynecological care, Manning said, though it alone would likely not be able to accommodate all of Roanoke Women’s Healthcare patients.

Women would still have to give birth outside of the county, she added, but the new clinic will help the hospital and the county, she said.

“They [Vidant Beaufort] were also really trying to increase their labor and delivery numbers,” she said. “So they had a need, they saw that we had a need and they said, ‘Hey, let’s sit down and talk about how we can all join together to meet the needs of the women in Martin County.’”

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Liora Engel-Smith

Liora Engel-Smith joined NC Health News in July 2019 and covers policies, programs and issues that affect rural areas. She has previously worked for the The Keene Sentinel in New Hampshire and the Muscatine...