As a growing number of rural hospitals stop providing planned baby deliveries, Minnesota patients in small towns are struggling to access care, public radio station KNOW reports.
Hospitals often cite legal and insurance costs as reasons for eliminating scheduled baby deliveries, but rural hospitals find it hard to attract physicians to small towns and often must consolidate birthing centers.
It's a trend that has created a lot of problems for rural communities and couples across the U.S. and new risks for pregnant women who must travel hours to deliver their babies.
Grand Marais, Minn., sees this problem firsthand. North Shore Health hospital in Grand Marais stopped delivering babies in 2015.
Although the 16-bed critical access hospital still handles many of the community's healthcare needs, such as prenatal and postnatal care, closing the birthing center led to a dilemma for the area's expecting couples.
The number of hospitals in Minnesota offering birth services dropped by about 18 percent between 2000 and the start of 2015. And rural Minnesota has been hit the hardest: Fifteen of the state's rural hospitals stopped delivering babies during that time — a nearly 38 percent decline.
The decline in services has led to longer drives and bigger worries for would-be parents.
A recent study from Minneapolis-based University of Minnesota study found a significant jump in patient anxiety when the Grand Marais and Ely, Minn., hospitals stopped providing labor and delivery services in the summer of 2015.
The study also described women's worries about the future of their communities when hospitals stop delivering babies.
"I feel like a second-class citizen. ... I feel that the government does not care about rural residents," one person in the study said. "I was outraged, extremely sad, scared (I was pregnant with my second child), and nervous! It is definitely a major loss for the community."
More than half of the nation's rural counties lack obstetrics care, and that number is increasing as rural hospitals manage pressures that are forcing many to stop these services.
"These factors all work together to render some communities deeply vulnerable to poor outcomes around the time of childbirth," said University of Minnesota professor Katy Kozhimannil, PhD, who studies rural healthcare trends.
"And when I say something like poor outcomes around the time of childbirth, I'm not sure that fully conveys the tragedy of losing a mother or losing a baby," Dr. Kozhimannil said. "It's something that can really destroy a life. It can destroy a family, can destroy a community, and it's happening more often in some communities than others."