Reason not to stay

Like Mr. Pratt, Bedford County Commissioner Barry Dallara worries about losing a community asset.

“It’s easy to cut something,” Mr. Dallara said. “Try to get it back. What you’ve done is given our youth one more reason they’re not going to stay in this county.”

Bedford County, which is mostly agricultural, has been slowly losing population, eroding 3 percent to 48,325 in 2016 from 49,768 in 2010, according to census data.

But critics are not hopeful about their chances of reversing UPMC’s decision, even though Mr. Pratt said he plans to “continue to beat the drum as long as we can.”

If history is any lesson, their odds of success are limited.

Despite protests that included a citizens’ march, UPMC closed the childbirth unit at the Greenville campus of the UPMC Horizon Hospital in Mercer County in 2007. Mothers-to-be were referred to Horizon’s Shenango Valley Hospital 17 miles away in Farrell.

About 400 babies were born annually at the Greenville campus when it closed, down from 863 in 1983.

That was followed by OB unit closings at independent hospitals including Monongahela Valley in 2007; Ellwood City in 2013; Grove City Medical Center in 2014; and the former Jameson Hospital in 2015. Also closing its maternity unit in 2015 was the 111-bed Somerset Hospital — an hour’s drive from Bedford — which sent expectant mothers 27 miles away to Johnstown in Cambria County.

UPMC closed the maternity unit at its Passavant Hospital in McCandless in 2003, although the drive to Magee-Womens Hospital of UPMC in Oakland, where mothers were referred, was just 12 miles. Nearly 11,000 babies are born annually at Magee.

Hospitals nationwide fuel the trend.

St. Joseph’s Hospital in St. Paul, Minn., closed its maternity ward in September. And Cleveland Clinic in Ohio closed its labor and delivery suite at Medina Hospital in June as the national birth rate slipped 4 percent between 1990 and 2015, according to the Pew Research Center.

Waiting for water to break

The impact of losing a maternity unit in a community can be hard to quantify.

There have been attempts.

Twelve years of birth records from rural Missouri towns where hospital obstetrical services had been discontinued, 1990 to 2002, revealed an increase ranging between 4.1 percent and 31.6 percent in the number of low birth weight babies born in the year following the closings, according to a 2008 study that appeared in the Journal of Rural Health.

“Increased frequency of low birth weight infants may be an indication that adverse health effects are increased,” the authors wrote. “Loss of obstetrical services may be a major factor in the decline and failure of small, rural communities.”

A 45-minute drive separates UPMC’s Bedford and Altoona hospitals in good weather. Travel times may be longer for Bedford residents who live in some of the county’s hamlets, which Mr. Pratt said “died on the vine 20 years ago.”

Alyssa Yothers, 24, lives in Schellsburg, population 331 and a 40-minute drive from UPMC Altoona Hospital. She is expecting her third child Dec. 19, weeks after the maternity unit at UPMC Bedford is scheduled to close. Labor began within 20 minutes of her water breaking during her last pregnancy, she said, which makes her “nervous” about making it to Altoona in time.

Ms. Yothers, a logistics coordinator at Rockland Manufacturing, said she is preparing to call the local ambulance if her water breaks when she is at home.

Middle school guidance counselor Megan Rose had both her children at UPMC Bedford Memorial, including daughter Ruby Estelle three years ago. The prospect of having to drive instead to Altoona makes her anxious, she said, especially since a friend’s baby was born at UPMC Bedford just seven minutes after she got there.

“The staff was just

Not everyone sees the loss of the maternity ward as a body blow to Bedford County.

Susan Koontz, the 52year-old director of admissions at a nursing home in Everett, who was born at UPMC Bedford, said patients will miss the intimacy of the childbirth experience where “you could see the same people who took care of you at the hospital, who helped deliver your children, at the grocery store.”

“I hate to see any serv i c e s cut,” said Ms. Koontz, who lives with her husband and two children on a 350-acre farm. “But I don’t think it will deter anyone from living here.”

What is clear is the common vision that Bedford’s economic future is yoked to the county’s only hospital.

In an Oct. 10 letter to UPMC Bedford Hospital asking that the closure be reconsidered, the Bedford Sunrise Rotary said it had a lot in common with UPMC, including “promoting peace” and “growing local economies.”

Closing the maternity unit in Bedford will “have many negative ripple effects” for employers and prospective employers, Rotary president Michael Lamb wrote.

Perhaps nowhere are the ties between the business community and the hospital more apparent than at Rockland Manufacturing, which advertised for 20 jobs when it opened in 1974 in Bedford and saw 350 people apply.

Since then, the payroll expanded 10 times to cover 200 people as the plant was enlarged four times, putting an industrial space bigger than a football field under roof as the company switched to UPMC Health Plan to insure its employees.

The contract gives the amazing and wonderful,” workers access to the local Ms. Rose, 38, said about UPMC hospital. her experience at UPMC Opened in 1951 as the Bedford. “But if I were Memorial Hospital of Bedford looking to move here, County, the facility come from a different replaced two smaller hospitals area, would I choose to at a time when the live closer to Altoona? country was in the midst Maybe I would choose of the post-World War II somewhere else.” baby boom. UPMC acquired

Nationally, f e w e r the hospital in 1998. births, staffing difficulties Now, telemedicine technology and financial issues were links Bedford to among the reasons cited UPMC’s Magee-Womens for closing hospital childbirth and Children’s hospitals units in a study by in Pittsburgh, giving the University of Minnes women with high-risk o t a School of Public pregnancies access to maternal, Health in 2016. And momstofetal medicine specialistsbe bore much of the burden at Magee, while of the closings. the Bedford hospital has

“Having to travel for obstetric undergone nearly $9 million care is associated in capital improvements with higher costs, greater during the past five risk of complications, and years. longer lengths of stay Meanwhile, UPMC is along with financial, social pressing ahead with plans and psychological to build three specialty stress for patients,” the authors hospitals in Pittsburgh at wrote. a total cost of $2 billion

Money was not an issue while joint-replacement in UPMC’s decision, hospital operations were phased officials say. out a few years ago at

UPMC Bedford’s net UPMC Bedford, with patients patient revenue rose 33 referred instead to percent to $57 million in the bigger Altoona hospital. fiscal 2016, from $43 million Bedford also stopped in fiscal 2013, a period inpatient dialysis Oct. 29 when the percentage after a provider pulled out of uncompensated because there were not care to net patient revenue enough patients — five in ratio steadily declined the last six months, Ms. at hospitals statewide, Manko said. according to the “We’re not closing Bedford,” Pennsylvania Health she said. “To the Care Cost Containment contrary, we are continuing Council. to make it better, keep

Here’s another look at it viable to meet the needs UPMC Bedford’s fiscal of the community.” health: In terms of threeyear Mr. Pratt still worries. average annual increases UPMC Bedford should in patient revenue, focus on providing basic Bedford ranked third medical care rather than among UPMC’s Pennsylvania “lusting after corporate efficiencies,” hospitals at 10.74 the businessman percent, trailing UPMC said. “This isn’t supporting East in Monroeville, 20.01 Bedford at all.” percent; Oakland-based Magee-Womens, 27.52 percent. The statewide average was 4.59 percent.