Monday, October 16, 2023

Alabama's Bloody Tide

Alabama Republicans have been refusing federal Medicaid expansion money for years now, and like most non-expansion red states, more and more hospitals are reducing services or closing up entirely as a direct result. Three hospitals near Bimingham are shutting down their maternity wards over the next several weeks, leaving tens of thousands of women without a place to go to deliver babies by Thanksgiving.
 
By the end of the month, two Alabama hospitals will stop delivering babies. A third will follow suit a few weeks later.

That will leave two counties — Shelby and Monroe — without any birthing hospitals, and strip a predominantly Black neighborhood in Birmingham of a sought-after maternity unit.

After that, pregnant women in Shelby County will have to travel at least 17 miles farther to reach a hospital with an OB-GYN. And because the county, one of Alabama’s largest, is bordered by another whose hospital also lacks an obstetrics unit, some of those residents are also losing the closest place they could go to deliver their babies.

“There’s a sense of dread knowing that there’s going to be families who are now not only driving to the county over, but driving through three counties,” said Honour McDaniel, director of maternal and infant health initiatives for the March of Dimes in Alabama.

People in Monroe County, meanwhile, could face drives between 35 to 100 miles to a labor and delivery department.

Trekking that far to give birth is not unheard of in Alabama, in which more than a third of the counties are maternity care deserts, according to the March of Dimes — meaning they have no hospital with obstetrics care, birth centers, OB-GYNs or certified nurse midwives.

The state has one of the highest maternal mortality rates in the country; only three others had higher rates between 2018 and 2021, according to the Centers for Disease Control and Prevention. Alabama also had the nation’s third-highest infant mortality rate in 2021, the latest data available.

Physicians currently or formerly affiliated with the Alabama maternity units about to close fear the consequences for pregnant women and babies, especially if people are not able to reach birthing hospitals quickly enough in emergencies.

“People are going to show up delivering in the ER, and you’re going to have bad outcomes,” said Dr. Jesanna Cooper, an OB-GYN who formerly worked at Princeton Baptist Medical Center, the Birmingham hospital closing its maternity services. “If you show up with a very premature baby and deliver in the ER, and you don’t have a NICU and you don’t have an obstetrics team, things aren’t going to go well.”
 
And of course the real kicker:

The closures come as the need for obstetrics care in Alabama is anticipated to rise as a result of its abortion laws. The state has banned almost all abortions since June 2022.
 
At this point, one would have to believe that the state Republican party, having banned abortion, and the same party letting hospitals die on the vine like this, really don't want those people to have sex at all without potentially ruinous consequences.  

When we talk about Alabama having a similar socioeconomic profile to say, Albania, understand that a poor exploitable populace is what the ruling government wants, and has wanted, for generations.

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