Another Alabama hospital to close labor and delivery services

Monroe County Hospital in south Alabama will close its labor and delivery department on Nov. 15, becoming the third hospital in a month to announce the end of health services for pregnant women and newborns.

The announcement follows news that two labor and supply departments in the Birmingham area will close by the end of the month. Doctors at Princeton Baptist Medical Center and Shelby Baptist Medical Center will stop delivering babies after Oct. 24.

Labor and delivery units have been disappearing across Alabama for decades. The latest closures will affect women in downtown Birmingham, a suburb of fast-growing Shelby County, and rural Monroe County, which sits halfway between Mobile and Montgomery.

A statement posted Oct. 3 on the Monroe County Hospital Facebook page said staff were “heartbroken” about the decision to end labor and delivery.

“Since February, we’ve known this closure was a distinct possibility,” the post said. “Please understand that we have done everything we can to avoid this closing. As with many rural hospitals, our plan going forward is to take OB patients to the nearest facility. Our emergency staff, along with the obstetric staff, have immediately begun training nurses and doctors.

Alisha Bowen of Monroeville was 25 weeks pregnant when she learned she couldn’t deliver at a local hospital. Bowen, who was seeing a specialist at USA Health, scheduled a mobile delivery in 90 minutes.

Figure shows which counties had labor and delivery services in 1980 and 2019. The closures hit rural districts the hardest.

“It will probably be a planned induction or a planned C-section,” she said. “I was hoping to be natural, but that wasn’t going to be the case because I wasn’t planning on having a baby on the side of I-65.”

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Still, Bowen considers himself lucky. She has reliable transportation and other resources that make the long journey difficult, but not impossible.

“We already have women in the northern part of the county who are struggling to get transportation to Monroeville, much less to Montgomery or Mobile,” Bowen said. “It will certainly affect residents with fewer resources more negatively.”

Monroe County Hospital is integrating the training with obstetrics and emergency staff and moving some nurses from labor and delivery to the emergency department, according to a Facebook post.

The latest closures are the latest in a long-term trend. The number of hospitals with labor and delivery services in Alabama has declined over the past four decades, particularly in rural areas. According to the Alabama Rural Health Association, the number of rural counties with obstetrics departments fell from 45 in 1980 to 16 in 2019.

A recent report by the March of Dimes found that some women in rural Alabama have to drive more than 70 miles to get to a hospital with obstetric care. Nearly 28 percent of Alabama women live more than 30 minutes from labor and delivery services, compared to 9.7 percent nationwide.

When Monroe County Hospital closes its labor and delivery department, it will leave the county without services for pregnant women. Closest is Grove Hill Memorial Hospital with obstetrics, 45 minutes away in Clark County.

About half of Alabama’s pregnant women are covered by Medicaid, the state’s health insurance program for low-income people. Reimbursement rates for Medicaid are lower than private insurance.

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The closures come at a time when the state is struggling with poor child and maternal health. Alabama had the third highest maternal mortality rate between 2018 and 2020, according to the US Centers for Disease Control and Prevention, and the third highest infant mortality rate in 2021.

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