Assessing the impact of maternity unit closures in Massachusetts
While Massachusetts technically has no maternity “deserts”—counties with no obstetric providers and no hospitals or birth centers offering obstetric care—many communities face inequities in maternal health care that need to be more effectively measured and addressed, according to Harvard T.H. Chan School of Public Health’s Alecia McGregor.
In a Sept. 8 interview on The Codcast, a podcast produced by CommonWealth Beacon, McGregor, assistant professor of health policy and politics, spoke about dwindling maternal health care access in Massachusetts. The state has seen 13 maternity service closures since 2010, including the closure of two hospital maternity units in the past nine months alone. Some women have reported giving birth in ambulances and emergency rooms and feeling generally less safe after their local maternity units closed.
The closures are part of a national trend, McGregor said.
“Nationwide we are seeing a very disturbing trend of hospital maternity ward closures,” she said. “Hospitals tend to see labor and delivery as a money loser. Running a labor and delivery unit is extremely costly because it has very high fixed costs, and it requires around-the-clock staffing.”
While obstetric care is available in every Massachusetts county, McGregor said that such a metric hides what many pregnant individuals face trying to access health care. Measuring the availability of maternity care by county is “too broad a measure to really capture the inequities in where hospital obstetric units are and where they’re more likely to close,” she said. “We definitely need a more precise measure of maternity care deserts in the state,” she said.
Recent maternity unit closures in Springfield and Methuen represent business-based decisions that are short-changing patients in underserved communities, according to McGregor. “There’s quite a bit of literature that shows that both maternal and neonatal outcomes deteriorate in the immediate aftermath of these closures,” she said. She added that while the state has limited enforcement power to prevent private hospitals or health systems from closing maternity units, it’s important for regulators to look out for any opportunities to keep them open.
Listen to the Codcast episode:
Massachusetts’s dwindling maternity care
Learn more
Maternity ward closures exacerbating health disparities (Harvard Chan School news)
