Labor and delivery departments are shutting down rapidly across the state of Alabama, which leaves rural moms-to-be with difficult decisions to make.
There is a definite, alarming downward trend, and the above infographic, based on statistics from the Alabama Department of Health, shows the rapid demise of available L & D departments for the state’s population, particularly in rural areas. In 1980, 46 of the state’s 54 rural counties had an L & D department available, and that number has dwindled to only 17 today. In all, Alabama has hospitals that can deliver babies in only 29 counties total.
This has an obvious impact on residents in those rural counties, who must plan ahead for a one- to two-hour trip to deliver at a hospital. This requires so much forethought, and there are so many factors that you must consider before your big day arrives. What if you make the huge trip and your contractions peter out? What if the obstetrician on call doesn’t feel you’re making enough cervical progress and sends you home? What if your labor goes faster than you expected, and you have to pull over on the side of the road to deliver your baby? And it’s also likely that many moms and physicians will elect to schedule an induction (or a C-section) to save those travel worries, which often isn’t ideal for the mother or her baby.
AL.com reports that the reasons many hospitals are closing their L & D departments are mostly financial in origin — from malpractice insurance requirements to specific regulations that must be in place for a successful obstetrics department to the fact that some patients’ insurances are inadequate to cover costs. The cost of keeping the department open often causes enough financial strain that the hospitals feel they have no choice but to close up shop.
While this presents stress for women with adequate financial means, it can be an obstacle that is difficult to overcome for disadvantaged women, who often must face the choice of going to their local hospital’s emergency department and delivering at the hands of an ER doctor or staying at home.
And if you stay at home? It’s against the law — completely illegal — to be attended by a midwife in Alabama.
It’s distressing that women in Alabama are having their birth choices whittled down to so few options. It can be difficult enough to keep your birth plan in place under ideal circumstances, but it’s really sad when your options are few to none.