Maternity wards are closing in Oregon and at rural hospitals across the country

PO1 William "Chip" Nagel
..."Dr. Pamela Evans, who helped with deliveries for years and will stay on as a gynecologist, said she fears things like preterm deliveries, infant mortality and low-birthweight babies are bound to get worse. Prenatal care suffers when people must travel long distances or take lots of time off work for appointments, she said. Not all insurance covers out-of-state deliveries, and it's an hour or more to some alternative in-state hospitals that families are looking at.

A solution to the rural care crisis might be about two hours away, where a handful of women sat in a circle for a prenatal group meeting at The Farm Midwifery Center, a storied place in Summertown, Tennessee, that’s more than a half-century old. Midwife Corina Fitch led discussions and gave them individual checkups.

“This is the perfect place for me,” said pregnant mom Betsy Baarspul of Nashville, whose first child was born in an emergency C-section in a hospital. “It feels like you’re held in a way.”

Some states and communities are taking steps to create more free-standing birth centers. Connecticut Gov. Ned Lamont recently signed legislation that will license such centers to operate as an alternative for women with low-risk pregnancies.

Alecia McGregor, who studies health policy and politics at the Harvard T.H. Chan School of Public Health, said midwife-led birth centers "can be a very important solution to lowering costs within the U.S. health care system and improving outcomes.”

A report on deliveries at The Farm in its first 40 years showed 5% of clients were transported to the hospital.

Doctors told the AP that rural hospitals will need to be part of the equation, and they believe governments must do more.

Oregon politicians mobilized this summer and considered requesting the help of OB nurses from the U.S. Public Health Service Commissioned Corps, which largely responds to natural disasters and disease outbreaks. While the idea didn't pan out, the federal service sent experts to Baker City, who recommended several things, including looking into establishing a free-standing birth center.

County commissioner Shane Alderson — the husband of Alisha — said rural communities shouldn’t be stripped of health care options because of their size or the number of low-income people with public insurance.

“That’s not equitable,” he said. “People can’t survive like that.”"

Birth rate is dropping...when things are uncertain, people choose not to have children

Tough question to resolve. There are valid point on both sides.