Growing a human is a true labor of love. When the time comes for the arrival of the child, every mother wants to have reliable medical professionals ready to handle their needs. Pregnant women in rural areas have several risk factors, including insufficient prenatal care, tobacco and alcohol use during pregnancy, and few choices of providers/health plans. In some rural communities, women are being turned away from emergency rooms. Several women have suffered complications after being turned away.
The Emergency Medical Treatment and Labor Act (EMTALA) of 1985 requires every hospital in America with an emergency room treat those who arrive in labor, providing care at least until the child is delivered. The Act was passed to ensure that ERs could not refuse patients for lack of ability to pay. OB services in rural areas have declined since the beginning of EMTALA because of high costs and a lack of doctors. Rural counties without obstetric services grew from 24 to 44 percent.
Some ERs have not only denied treatment, but would not help women transfer to another facility either. These patients end up calling 911 from a nearby parking lot to get ambulance transport to a hospital that handles obstetrics. It is not known if these lapses are leading to the increasing pregnancy-related complications from hospitalization to stillbirth to maternal death.
At least 20 rural hospitals have been found in violation of EMTALA in the last five years. An EMTALA violation prompts CMS to cite the hospital for placing patients in “immediate jeopardy.” The problems must be fixed or the hospital will lose Medicare funding. Some hospitals with violations are making efforts to train staff on EMTALA and purchase new equipment to be better prepared for emergencies. Doctors who perform few deliveries could use simulations to maintain their skills.
Some hospitals continue to turn women away, even when aware of EMTALA’s requirements. Hospitals need to do better providing care to women in labor, even if they have closed their obstetric units.
Lasson, Julie. “Despite Federal Law, Some Rural Hospitals Still Turn Away Women in Labor.” Article. ProPublica, 3 Mar 2017. Web. 5 Mar 2017.