Pregnancy is a game of dates — due date, viability date, date of conception, etc. But for expectant mothers in Martinsville and Henry County, another date became incredibly important this year — May 2, the day Sovah Health-Martinsville’s labor and delivery unit ceased operation.
In April, Sovah Health CEO Spencer Thomas announced the unit would be temporarily paused and that labor and delivery services would be shifted to the health care operator’s Danville campus some 30 miles away. Thomas cited a 60 percent decline in deliveries at the Martinsville location since 2015.
According to the most recent birth statistics from the Virginia Department of Health, in 2020 190 live births occurred in Martinsville. Looking at live births by residence rather than where they occurred, Martinsville had 247 during the same year. The numbers show a fairly significant decline from 2019, when there were 319 live births occurring in Martinsville.
And according to United States Census data from July 2021, Martinsville has a population of just over 13,500 people, with the total population estimates for Henry County at a little over 50,200. That’s a slight drop from 2010 numbers, with Martinsville at a population of 13,821 and Henry County at 54,151. But comparing population estimates between April 2020 and July 2021, Henry County saw a 1.4 percent decline in population (approximately 700 people) while Martinsville saw a slight increase of 0.2 percent.
While the area has certainly seen a reduction in births and population, for mothers living in the area, the labor and delivery unit closure presents potentially significant issues in receiving the health care they need.
“It’s been an institution in the community for so long — Martinsville Hospital was one of those community hospitals where factory workers and other people in town actually contributed their own money to build the hospital,” said Dr. Makunda Abdul-Mbacke, an OB/GYN at Piedmont Preferred Women’s Health Care, which has practices in Martinsville and Eden, North Carolina. “The hospital is an integral part of the town, and we’re watching more and more services disappear, and it’s being mirrored all across rural America.”
The decline in rural access to health care has been an ongoing problem, exacerbated in many areas by the pandemic. According to United States Health Resources and Services Administration (HRSA) data, rural areas far outpace non-rural locations in the number of officially designated Medically Underserved Areas at 1,972 vs. 1,284 as of June 16, 2022. An additional 332 partially rural areas fall into the designation. Medically Underserved Areas are defined as geographic areas, populations and facilities that have too few primary care, dental and mental health providers and services.
“With our population of patients, travel is especially difficult,” said Marcus Stone, executive director, Martinsville-Henry County Coalition for Health and Wellness. “A population of people who are underserved or underinsured may not have the financial resources to make to their appointments in another town. Anytime we refer them out of town to a specialist, that can be a struggle for them to accommodate.”
A significant number of Martinsville and Henry County residents struggle with poverty and lack of health insurance. According to current U.S. Census data, 8.4 percent of Martinsville residents under age 65 don’t have health insurance, and the city has a poverty rate of 21.3 percent. In Henry County, 11.4 percent of residents under age 65 are without health insurance, and 12.9 percent live in poverty.
“For people with limited incomes, especially with the price of gas, I encourage patients to take advantage of the Medicaid transportations services, but in the middle of the night when you’re water breaks, you can’t call them,” Abdul-Mbacke said.
Abdul-Mbacke said that while patients in an emergency situation can call an ambulance and be seen in the emergency room in Martinsville, delivering a baby in an ER rather than a labor and delivery unit can be risky.
“The potential for babies to be born in the emergency room is not a good thing, particularly if the baby is premature, you might not have as good of an outcome,” she said. “Places that don’t have OB/GYNs do see increased maternal mortality and infant mortality. As OB/GYNs, we spend four years practicing and specializing, and without the ability of having trained OB/GYNs readily available, health care will suffer in the community.”
The lack of readily available healthcare services for expectant mothers can impact the community in other ways, as well.
“Anytime a community loses any kind of health care service, it puts them at a disadvantage from a recruitment perspective, not just talent for jobs but populations to come into the community,” Stone said. “If you have a broad array of health care services, you attract a broad array of people. When you decrease those services, you decrease the attractiveness of the area — if I’m looking for a place to raise my young family and if I’m planning to have children in the coming years, a lack of obstetric services is something to consider.”
While Sovah Health didn’t respond to a request for comment, Stone, who whose foundation works closely with the hospital to provide health services for the community, said Sovah doesn’t take this decision lightly.
“This change in services or temporary halt in services was difficult for them, as well, and we work to support them in this effort,” he said. The Martinsville-Henry County Coalition for Health and Wellness also received funding from the Harvest Foundation, which was established with funds from the sale of Martinsville Hospital to Sovah.
In the meantime, Abdul-Mbacke said the loss of this service will likely impact not only the community, but the hospital, as well. And she hopes the community will step up to fill in the gaps for families in the region.
“Obstetrics in and of itself usually doesn’t make money for a hospital, but it’s a service that brings in the whole family because mothers make decisions for health care for the entire family,” Abdul-Mbacke said. “I hope that people in the community will come together and figure out a way to improve the health care of moms and babies.”