Doctors: Mortality rate will increase

Published 8:12 am Wednesday, April 6, 2011

The potential closure of Bryan W. Whitfield’s labor and delivery department has sparked concern among the doctors who use the facility and provide the service.

According to a study by the Southeast Alabama Medical Center in Dothan, approximately 17 percent of households in Marengo County do not own an automobile. Dr. M.J. Fitz-Gerald, who also serves as chairman of the hospital board, said those residents are put at the most risk by the closure of the hospital’s labor and delivery unit.

“Getting a ride two or three miles to town for a doctor visit is one thing,” he said. “Getting somebody to drive you 70 miles one-way a few times a month is another.”

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The Bryan W. Whitfield Memorial Hospital (BWWMH) hospital board voted last week to close the department within the next 60 days, citing largely the financial losses of its operation.

Fitz-Gerald, who has delivered babies at the Demopolis hospital since 1965, said the ramifications of closing labor and delivery could be catastrophic.

“The mortality rate of mothers and babies will go up,” he said. “I think they’re not going to be able to get the proper care they need. The infant mortality rate will go sky-high.”

The closure of the unit leaves to question where many expectant mothers who live near or under the poverty level will turn for obstetric (OB) care when labor and delivery services are no longer offered locally.

Fitz-Gerald, who voted to keep the unit open, said many mothers would not turn to the Emergency Room as many suspect they would. He said most would likely turn to “nannies” or midwives to berth their babies.

“Then, they’ll have the babies in their own nasty beds,” he said. “You’ve exposed the mother to serious infection and that’s not to speak about any possible complications or effects on the baby.”

Among the other concerns shared by local Family Practice and OB doctors was the residual impact on other areas of practice.

“What do you think that’s going to do to pediatricians around here,” Dr. Alex Curtis asked. “Those doctors in Tuscaloosa are going to tell that mother that when your baby gets sick, you just bring him right on back here. Same thing for (gynocological services) GYN.”

Mike Marshall, BWWMH Administrator, said he and the board took the potential for dilution of other services into account before making their decision, adding he anticipated any impact on pediatrics would be minimal.

“It’s going to have some impact I’m sure,” he said. “I talked with Dr. (Brenda) McGivern (BWWMH pediatrician) and we both think there will be some impact but don’t expect it to be anything major.”

Curtis, who serves as the Emergency Room Director at BWWMH, said relying on ER staff to deliver babies in emergency situations was not a suitable answer.

“ER doctors have some OB training,” he said, “but they’re not trained in OB. There’s a big difference. If you don’t practice something regularly, you lose that skill. Some family practice doctors do a two or three month rotation in OB in residency. They’re trained, sure. But they’re not OB doctors.”

Curtis added that, while qualified services for the mother would be cut, similar services for the baby would be virtually non-existant.

“We won’t have qualified OB nurses. There’s no one qualified to take care of the baby,” he said. “If we stop OB, babies will die or will have significant outcome problems.”

Dr. Gerald Hodge said the elimination of labor and delivery will take with it doctors’ ability to quickly detect possible complications, thus potentially saving the lives of mother and baby.

“Sometimes you have to bite the bullet and do what’s best for the patients and what’s best for their benefit,” he said. “Shutting down labor and delivery just isn’t it.”