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It’s Not a Good Idea to Make Things Harder for Pregnant Women

It’s Not a Good Idea to Make Things Harder for Pregnant Women

New York’s health care system has been in the news this year as communities across the boroughs fight against hospital closures and reduction of services. Most of these cost-cutting measures have targeted low-income communities, making it harder for them to access health care. This week, a particularly unsettling piece of news out of the Bronx, where prenatal and delivery services at the North Central Bronx Hospital (NCBH) were abruptly cut with no notice, diverting patients and staff alike to Jacobi Medical Center, which is four miles away.

Hospital closures don’t reduce the number of patients, but instead shift them to other locales and put pressure on remaining facilities. For people in low-income communities relying on public hospitals for services, closures can be devastating. The closest hospital may be difficult and/or expensive to reach, continuity of care can be disrupted, and when patients do arrive at one of the hospitals that remains open, a scene of chaos can await them.

As public hospitals struggle to deal with an influx of new patients in the wake of closures of other hospitals, they’re stretched to capacity, which means long waits for triage in the emergency room, difficulty finding enough beds for patients, and more problems. Patients may be crammed into rooms, for example, or may have to wait extended periods of time for equipment to be available for medical testing and treatment.

When it comes to prenatal care, disrupting continuity of care can potentially have very dangerous consequences. Low-income patients may have trouble getting to appointments as it is, and yanking a care provider and hospital out from under them can leave them flailing. Some may not follow up and establish a relationship at the new hospital, and any problems with the pregnancy will go undetected. Others may struggle to get to appointments and could find that they’re forced to wait longer for shorter sessions with care providers.

Once former NCBH patients go into labor, they’re going to be forced to travel four miles out of the way, which can make a critical difference if a crisis emerges during labor and delivery. Four miles may not seem like much to people with cars who live in areas with clear streets, but in New York, four miles can become a life and death issue. As patients in active labor arrive at a hospital they may have never been to before, the hospital’s overcrowding can cause problems with intake, getting the patient into a room, and, of course, providing support while the patient labors and delivers the baby.

NCBH used to have a pioneering midwifery program, making midwife services available to low-income women and providing full outreach and support for patients who preferred midwives to obstetricians. Those services are no longer available, which upsets continuity of care for patients who have been seeing midwives for their pregnancy up to this point, and narrows down the options for all patients. The loss of the award-winning program is a harsh blow for the any women who benefited from it.

Nurses are reporting that the situation in the wards at Jacobi is troubling. Patients are warehoused six to a room because the hospital is struggling to cope with the extra patients from NCBH, and there aren’t enough staff members to meet their needs. Some new parents are waiting 12 hours to see their children because the hospital didn’t have security procedures in place in the new units — and it’s important to make sure babies are protected from kidnapping, accidental swaps and other safety and security risks.

Such conditions wouldn’t be tolerated in a private hospital, and they shouldn’t be tolerated in a public one, either. New York’s hospitals need the support of their communities not just to stay open, but to maintain critically important departments and programs. The people of New York have shown themselves to be more than capable when it comes to defending their hospitals this summer, fortunately, but the battle is far from over.

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Photo credit: christina rutz.

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92 comments

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6:37PM PST on Nov 11, 2013

smh

11:28AM PDT on Oct 6, 2013

Had my second child in a public hospital. The care was fantastic, but I would have died, as would my trying-to-be-born baby if I would have had to go too much farther for care. Ended up with a c-section. Really wish these idiots could get pregnant and have at least one child before they start cutting essential services to the poor. Wonder how many use viagra...and get it at reduced costs??

4:42AM PDT on Oct 2, 2013

tyfi

2:14AM PDT on Oct 2, 2013

Respect is something these extremists do not have when it comes to women. They do not seem to understand that you cannot just take away one human being's rights in order to "give rights" to another. I will never understand that. It especially makes me sad when I see women doing it to other women. Saying they must surrender control over their own body. I was not born from a government womb, my body is my own, they need to leave it the hell alone.

As for some of the extremist men? If you ever dared to suggest for one minute that maybe we didn't need to invest so much time and effort into creating/improving the latest male enhancement/virility/testosterone pill/deodorant/etc, or that maaaaybe it shouldn't necessarily be covered by insurance in all cases...walls would fall.

Bugger the population explosion or the planet's need to remain sustainable. Forget the fact we still haven't come up with a cure for cancer, aids, etc. etc.while making more and more of this stuff that gets washed down drains, messes with the environment, and gives horrible side-effects to women/children if they come in contact with it. And don't forget! Make sure it's free for all men who want it, whether they NEED it or not! Because you know, it's their body and they should be able to do what they want with it!

Respect? For women though? Surely you jest.

8:26AM PDT on Sep 30, 2013

Hospital closures are an inconvenience, for sure, and responsible people should make changes in where they will receive their care as soon as possible. I've had doctors who retired or moved away and I have always been given a referral to a new doctor and the information on where my records are located and I know that, by law, that would have been done here in New York. I had both my children at hospitals where I had never been as a patient before... it was my OB-GYN who I knew or would have been mid-wife had I preferred... and that was sufficient.

"The loss of the award-winning program is a harsh blow for the any women who benefited from it."
Yes, I'm sure it is a harsh blow... now, follow up on your own care and then go on with your life.


7:25AM PDT on Sep 30, 2013

Thanks for sharing. This is so sad. This is why we need ACA. Everyone should have access to medical care.

5:15AM PDT on Sep 30, 2013

More than ever people have to think very seriously IF they really can have the children that they want!

4:57AM PDT on Sep 30, 2013

ty

4:43AM PDT on Sep 30, 2013

it sounds retrogressing

4:11AM PDT on Sep 30, 2013

thanks

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