{"id":885,"date":"2024-05-01T12:04:52","date_gmt":"2024-05-01T12:04:52","guid":{"rendered":"https:\/\/retirednurseblog.com\/index.php\/2024\/05\/01\/the-hospital-where-this-mom-to-be-plans-to-deliver-her-first-child-is-more-than-an-hour-from-her-home\/"},"modified":"2024-05-01T12:04:52","modified_gmt":"2024-05-01T12:04:52","slug":"the-hospital-where-this-mom-to-be-plans-to-deliver-her-first-child-is-more-than-an-hour-from-her-home","status":"publish","type":"post","link":"https:\/\/retirednurseblog.com\/index.php\/2024\/05\/01\/the-hospital-where-this-mom-to-be-plans-to-deliver-her-first-child-is-more-than-an-hour-from-her-home\/","title":{"rendered":"The hospital where this mom-to-be plans to deliver her first child is more than an hour from her home"},"content":{"rendered":"
\n

Mom-to-be Stephanie Zuroski hopes she recognizes the signs of labor quickly, because the hospital where she plans to deliver her first child is more than an hour from her home in rural Elk County, Pennsylvania. <\/p>\n

Elk County is about 2\u00bd hours outside Pittsburgh, nestled at the edge of the Allegheny National Forest. <\/strong>Zuroski grew up on a farm and is familiar with the tradeoffs that come with rural living. <\/p>\n

\u201cI am accustomed to driving to get the things that I need,\u201d said Zuroski, 32. <\/p>\n

What she didn\u2019t expect was the lack of labor and delivery units in the county, which means she\u2019ll have to drive out-of-state to give birth in a hospital. <\/p>\n

\u201cWhen I started looking into pregnancy and [obstetrician] care, I was shocked local hospitals weren\u2019t delivering babies,\u201d Zuroski said. <\/p>\n

In February, the Penn Highlands Healthcare hospital system announced that it was \u201crealigning services\u201d and moving labor and delivery services from Penn Highlands Elk\u00a0\u2014 the only hospital in the county \u2014\u00a0to its sister hospital Penn Highlands DuBois, about 30 miles south in Clearfield County, on May 1. The shift limits maternal health care options in the area, and could raise the risk of people delivering in riskier conditions \u2014 even at home or in their cars. <\/p>\n

New and expecting mothers would still be able to get scans, tests and exams at Penn Highlands Elk, but they will no longer be able to deliver there. <\/p>\n

The hospital in DuBois has the only neonatal intensive care unit within 100 miles, according to Penn Highlands Healthcare, and is staffed to handle high-risk deliveries. <\/p>\n

\u201cThe transition is designed to offer a higher level of care for mothers and newborns,\u201d the health system said in a\u00a0news release. <\/p>\n

It added that the declining number of births at Penn Highlands Elk was another factor in the decision. <\/p>\n

Maternity care deserts<\/h2>\n

The closure of the labor and delivery unit leaves five counties with limited access to a labor and delivery unit.\u00a0Two of the counties, Forest and Cameron, are considered by maternal health nonprofit March of Dimes to be maternity care deserts:\u00a0<\/strong>areas without\u00a0obstetric providers\u00a0and without a hospital or a birth center offering obstetric care. <\/p>\n

\u201cThis is a devastating thing that is happening. Women are struggling to have access before, during and after their pregnancy journey,\u201d said Barbara Roth, March of Dimes executive director of market impact in western Pennsylvania. <\/p>\n

\u201cThe farther a woman travels to receive maternity care, the greater the risk of maternal morbidity and adverse infant outcomes, such as stillbirth and NICU admission. Furthermore, longer travel distances to care can cause financial strain on families and increased prenatal stress and anxiety,\u201d March of Dimes says in a\u00a0report. \u201cThe distance a woman must travel to access care becomes a critical factor during pregnancy, at the time of birth, and in the case of emergencies. Nationwide closures of birthing hospitals have contributed to increased distance and travel time to care, especially in rural areas.\u201d <\/p>\n

Roth said the nonprofit advocates for the expansion of access \u201cto doulas, midwives and telehealth\u201d and held an advocacy day at the Pennsylvania Capitol in March to raise awareness about maternal and infant health care concerns such as these access issues. <\/p>\n

\u201cIn the state of Pennsylvania, women living in counties with the highest travel time could travel up to 42.7 miles, and that\u2019s about 57 minutes on average \u2026 to reach their nearest birthing hospitals,\u201d Roth said. <\/p>\n

Statewide, March of Dimes says, about\u00a07.5% of counties\u00a0in Pennsylvania are maternity care deserts, and about 12% of women don\u2019t have access to a birth hospital within 30 minutes of them. <\/p>\n

Certified nurse midwife Lauren Narbey said the situation in Elk County is a familiar one. <\/p>\n

When WVU Medicine Uniontown Hospital in Fayette County\u00a0closed its birthing center in 2019, she saw \u201ca huge increase in the number of patients\u201d who drove 45 minutes or more to deliver their babies at Jefferson Hospital in Allegheny County, Pennsylvania, where she has worked since 2018. <\/p>\n

\u201cIt\u2019s a very high-risk area, not a lot of health care at all available,\u201d Narbey said of Fayette County, which is on the border with West Virginia. \u201cSo patients are now having to drive sometimes two hours to get to Labor and Delivery.\u201d <\/p>\n

Uniontown Hospital has since announced that it is re-establishing its obstetric services. <\/p>\n

At her hospital, Narbey says, she has seen patients come in to deliver without any prenatal care, simply because of the distance to the hospital and the lack of resources or support at home \u2014 especially people with multiple children. Many of her patients ask to schedule inductions so they can avoid making the trek while in labor, she said. <\/p>\n

\u201cThis patient population really wants scheduled inductions at 39 weeks, which is the earliest we can offer without any kind of really risky complication necessitating delivery before then. And they really do want that, because they want to be able to plan the trip. They want to be able to plan child care. They don\u2019t want to have their baby in the car on the way. So I\u2019ve seen a huge uptick in people wanting an induction,\u201d she said. <\/p>\n

Emily McGahey, a midwife and the clinical director at\u00a0The Midwife Center\u00a0in Pittsburgh, said birth centers like hers also have clients who do their best to plan. <\/p>\n

\u201cSometimes, our families will arrange a time to come in and have a baby, or sometimes, they will labor and then maybe move to a closer family member or friend\u2019s home or get a hotel room closer by,\u201d she said, adding that clients at the center are typically discharged hours after birth and return for a checkup within the first 72 hours. <\/p>\n

And that\u2019s just the patients who are able to plan ahead; many don\u2019t make it in time for their deliveries. <\/p>\n

\u201cThat happens a lot for us,\u201d Narbey said. \u201cI mean, like a few times a month that patients will have babies at home or in the car and then they\u2019ll just bring them in the ambulance, and then we just cross our fingers that they\u2019re not hemorrhaging when they get here because their placenta is still inside.\u201d <\/p>\n

Seeking solutions<\/h2>\n

In Elk County, Nick Burdick, manager of the St. Marys Area Ambulance service, is preparing for the possibility that his team will be called upon to deliver babies more frequently and is working with Penn Highlands Elk to get up to speed on the latest labor and delivery technology. <\/p>\n

\u201cWe are certainly all trained in labor and delivery, although it\u2019s not something that we experience often. But with the news of this unit and service closing in our local hospital, we\u2019re absolutely taking the opportunity to increase our training and get more experience in labor and delivery and neonatal care,\u201d Burdick said. \u201cSo we will be working with Penn Highlands Elk in taking labor and delivery training as well as advanced neonatal life support, so they are willing and definitely helping accommodate us in their transition and giving us the resources and the education to be able to care for the community.\u201d <\/p>\n

Zack Pontious\u2019\u00a0pregnant sister-in-law was due May 1, the day the unit at Penn Highlands Elk is set to close. But the baby came early, saving her the 45-minute drive to Penn Highlands DuBois, said Pontious,\u00a0a member of the\u00a0Ridgway\u00a0Borough Council in Elk County. <\/p>\n

The new uncle says the council is limited as to what it can do to replace labor and delivery services in the area. <\/p>\n

\u201cBoroughs provide services like trash pickup and snowplow. We\u2019re not really in the business of providing health care,\u201d he said. <\/p>\n

After Penn Highlands\u2019 announcement, he and other local officials and business owners formed a group to with state representatives and come up with ways to support and incentivize the health care system to maintain its services in Elk County.\u00a0<\/strong> <\/p>\n

Despite their efforts, the system is still moving forward with its plan, frustrating Pontious, who moved to Elk County to be closer to family as he and his wife plan to start their own. <\/p>\n

\u201cMy wife and I moved here, and she never thought that this was a concern that we would have to have: that we\u2019d have to be fighting for women\u2019s services to be left in \u2013 not even our town \u2013 in our county,\u201d he said.\u00a0<\/strong> <\/p>\n

In neighboring Cameron County, Commissioner Joshua Zucal said officials are also exploring options to offset the closure of Penn Highlands Elk\u2019s labor and delivery unit, such as midwives to help with home births.<\/strong> <\/p>\n

\u201cCameron County was never notified or brought into the loop that this was occurring. It was just something that we had to hear through the news of it happening,\u201d he said. <\/p>\n

Zucal said it\u2019s not just maternal health care that is taking a hit in rural Pennsylvania;\u00a0some local doctors\u2019 and dental offices have also closed or relocated, and it\u2019s hard for Cameron County to attract enough people to work for emergency response teams in the area. <\/p>\n

\u201cThere are the basic needs communities must have, and we need to have access. It\u2019s not that we have lost all access, but you can see pieces of the puzzle falling apart,\u201d he said. <\/p>\n

The county commissioner said he is focusing on the solutions to try to remain optimistic. <\/p>\n

\u201cWhat are the things that we can implement to still have a thriving community, though there are challenges? How can we still focus on the quality of life that a rural community can offer? And then also the health and wellness aspects, that if you\u2019re a healthy person, the amount of care that you\u2019re going to need is much less than somebody who\u2019s unhealthy. So if we can create healthy communities, we won\u2019t need such a crutch and be so reliant on these organizations that choose to do things such as closing maternity,\u201d he said. \u201cSo we just need to figure out solutions to take care of our own.\u201d <\/p>\n

Many people think a birth, or birthing, center is the perfect solution for an area like Elk County. These centers \u2013 where people with low-risk pregnancies can deliver in a\u00a0home-like facility,\u00a0with more autonomy over the experience \u2013 are designed to \u201cprovide routine care and initiate emergency procedures\u201d and must be positioned close enough to a hospital where women can get c-sections if they need, according to the\u00a0American Association of Birth Centers. <\/p>\n

\u201cI think that\u2019s a really valuable resource that our community should look into,\u201d Zuroski said. \u201cIt\u2019s definitely a resource that I would consider using in the future.\u201d <\/p>\n

Narbey, acknowledging her perspective as a midwife, also agrees. <\/p>\n

\u201cThis is my biased opinion. I think midwives are part of the solution. Most women are low-risk, and we could staff a birthing center starting with three midwives, which is cheaper than an obstetrician, and midwives tend to be really good at connecting with their communities and meeting people in a culturally sensitive, appropriate trauma-informed perspective,\u201d she said, adding that communities in Alaska, Montana and South Dakota are turning to this model as a solution. <\/p>\n

Health care by ZIP code<\/h2>\n

Health care wasn\u2019t at the front of Zuroski\u2019s mind when she moved to Elk County in her mid-20s. Now, the the environmental engineer said she feels a deep connection to the community. <\/p>\n

It\u2019s vibrant and green in the spring and summer and awash with fall color in the cooler months, and Zuroski says she was drawn to the area by the sky-scraping trees and the \u201cbeautiful little mountain streams that hold wild trout populations.\u201d <\/p>\n

\u201cI\u2019m willing to compromise and give up some things in order to stay here and live where I\u2019m happy,\u201d she said. <\/p>\n

For now, Zuroski makes a 45-minute commute every four weeks to her appointments with a certified nurse midwife in Bradford, Pennsylvania, close to the New York state line. <\/p>\n

And when it\u2019s time for the baby to come in August, she plans to pack up and head to Olean, New York, now one of the closest hospitals to her with a maternity ward. <\/p>\n

\u201cTraveling far while in labor will be uncomfortable,\u201d she said. <\/p>\n

\n
    <\/ul>\n<\/div>\n

    McGahey says it is time for communities to step up to ensure that maternal health care remains accessible to families. <\/p>\n

    \u201cI think on a larger community level, we need to be advocating for us as a society to figure out how we value maternity care in our country because it\u2019s not valued,\u201d she said. \u201cAs we can see, all of these maternity care deserts in our counties, across our state and the country, and this is leaving hundreds of thousands of families without care. <\/p>\n

    \u201cWhere you live and where you choose to raise your family shouldn\u2019t affect the quality of health care that you receive,\u201d McGahey said. \u201cAnd I think that\u2019s the biggest issue right now is how we continue to show families support and take good care of them.\u201d <\/p>\n

    Narbey agrees. \u201cIn some cases, it can be a life-and-death situation, and that should never be the case. But unfortunately, your ZIP code determines more about your health outcomes than any other factor.\u201d <\/p>\n<\/p>\n

    This post appeared first on cnn.com<\/div>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"

    Mom-to-be Stephanie Zuroski hopes she recognizes the signs of labor quickly, because the hospital where she plans to deliver her first child is more than an hour from her home in rural Elk County, Pennsylvania. Elk County is about 2\u00bd hours outside Pittsburgh, nestled at the edge of the Allegheny National Forest. Zuroski grew up …<\/p>\n","protected":false},"author":1,"featured_media":886,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"loftocean_post_primary_category":0,"loftocean_post_format_gallery":"","loftocean_post_format_gallery_ids":"","loftocean_post_format_gallery_urls":"","loftocean_post_format_video_id":0,"loftocean_post_format_video_url":"","loftocean_post_format_video_type":"","loftocean_post_format_video":"","loftocean_post_format_audio_type":"","loftocean_post_format_audio_url":"","loftocean_post_format_audio_id":0,"loftocean_post_format_audio":"","loftocean-featured-post":"","loftocean-like-count":0,"loftocean-view-count":608,"tinysalt_single_post_intro_label":"","tinysalt_single_post_intro_description":"","tinysalt_hide_post_featured_image":"","tinysalt_post_featured_media_position":"","tinysalt_single_site_header_source":"","tinysalt_single_custom_site_header":"0","tinysalt_single_custom_sticky_site_header":"0","tinysalt_single_custom_sticky_site_header_style":"sticky-scroll-up","tinysalt_single_site_footer_source":"","tinysalt_single_custom_site_footer":"0","footnotes":""},"categories":[35],"tags":[],"class_list":["post-885","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-news"],"_links":{"self":[{"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/posts\/885","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/comments?post=885"}],"version-history":[{"count":0,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/posts\/885\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/media\/886"}],"wp:attachment":[{"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/media?parent=885"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/categories?post=885"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/tags?post=885"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}