New Haven Register (New Haven, CT)
High-quality maternal care has never been more important
With the summer’s repeal of Roe v. Wade by the Supreme Court shining a light on the importance — and precariousness — of women’s health care, we cannot let that attention stray, nor can we remain focused solely on the right to choose.
In September, the Centers for Disease Control and Prevention determined that a steep majority, more than 80 percent, of maternal deaths across a majority of the United States could have been prevented. When we discuss women’s reproductive rights, we need to consider the whole of pregnancy, including after birth. More than one-fifth of maternal deaths occurred during pregnancy, and another quarter during the first seven days — with the remaining 53 percent occurring within the first year of delivery. Mental health concerns, including suicide, overdose or substance use disorder, contributed to 23 percent of deaths, with bleeding, cardiac, infection, embolism, cardiomyopathy and hypertensive disorders also causing deaths.
Amid these concerning details — and the possibility that the maternal mortality rate rose by nearly four deaths per 100,000 births in 2020, with the potential for that statistic to rise further — the issue of ensuring high-quality care for all pregnant women and new mothers has never been more important.
Compounding the seriousness of this issue, especially here on a local level, is that Connecticut has lost several prominent birthing units in some areas of the state. Since 2010, at least four birthing units, including at Vernon’s Rockville Hospital, Stafford’s Johnson Memorial Hospital, Windham Hospital and Sharon Hospital, have closed, in many cases their parent companies citing costs or staffing issues. But these decisions have had very real and negative consequences for Connecticut women.
In addition to losing the ability to receive local care in individual communities, something that likely appeals to a majority of women seeking care, these decisions consolidate avenues for women to seek care to fewer locations, putting more pressure on fewer birthing units overall, which can reduce the level and quality of care women receive.
Additionally, it puts those women at more potential risk due to sheer challenge of care. Many women will now have to travel significant distances for doctor’s appointments, which not only can be a challenge for those without reliable transportation methods, but raises risks. In addition to everyday issues like requiring more extensive travel, fewer birthing units means that in the event of an emergency, it could take significant time for a woman to reach a location to receive care, which could negatively impact the health of both her and her child.
The hospitals that have closed these units claim that their actions were due to a lack of safe care in their operations, primarily due to a lack of OBGYNs in the state. For years, Connecticut has seen OGBYN populations drop, and in my opinion, we can do the most good on this issue by working to recruit and retain these individuals. Our medical schools are producing some of the best medical professionals in the country, but they are hard to retain. State policies have not been conducive to the best environment between low reimbursement rates and malpractice insurance lacking full protections for individuals’ property. This problem has the potential to rapidly expand even further across the state.
We cannot dilute the quality, extent and depth of education in Connecticut to solve this problem. Instead, we must identify solutions to retain physicians in our communities; women in Connecticut deserve excellence in quality of care. Most prominently, we need to look at workforce development and our workforce recruitment and retention strategies. Primarily, I will argue in favor of reimbursement and payment reform, as well as malpractice reform, to provide physicians with better financial support rivaling that of other states to match their metrics. If financial issues are the most prominent reason for this problem’s existence, we need to address them at the state level to solve it.
In doing so, we cannot miss the absolute need that, with more hospitals in the state consolidating under fewer companies and systems, we would do our state a disservice if we were not aware this issue could spread. We need to make sure women’s health and children’s health remain in the communities where individuals reside, to the point where our existing boards need to focus on restricting closure of these units without legitimate and provable reasons. If such a serious decision is being made, it cannot be made solely due to the prospect of financial gain; lives could be in the balance otherwise.
It’s clear to me that the state of Connecticut needs to take direct action, as soon as possible, to correct the course it is on. Otherwise, we run the risk of not just inconveniencing future expectant parents, but exposing them to health hazards and complications that could harm the health of themselves and their offspring.
We run the risk of not just inconveniencing future expectant parents, but exposing them to health hazards.