Maternity Care Crisis in Southeast Pennsylvania

Feminists are used to fighting for reproductive rights- for access to family planning services and contraception, for adequate health and sex education for our youth, and for access to safe abortion. In general, we don’t consider that access to maternity care is really a problem, but it is. Since giving birth is another way of saying ‘reproduction’, obviously all things concerning it are part of reproductive rights, and need the same protection our other rights need.

Lack of access to maternity care is a significant issue globally, and also here in the US. Amnesty International issued a report earlier this year called “Deadly Delivery”, and described the lack of maternity care access in the US as a failure to protect women’s human rights. They make a very good point. Reproductive rights are human rights for women.

In the 5-county Greater Philadelphia region, we’ve lost 20 maternity units in the past 13 years. We’ve lost 13 in Philadelphia. We now have only six remaining delivery hospitals in Philadelphia. Mercy Suburban in Montgomery County was the most recent hospital to close its maternity unit. Now Montgomery Hospital is feeling the fiscal drain of picking up the slack. That’s the trend: a hospital closes its maternity unit, those births happen somewhere else and strain the resources of another unit until it, in turn, is closed. The problem keeps growing without solution.

Why do hospitals keep closing their maternity units? We are told it’s because it’s unprofitable. That’s right, childbirth is unprofitable. This is an absurdity of our current health care ‘system’. The more births a hospital gets, the deeper it goes in the hole. In most businesses, more business would mean more profits, but apparently childbirth is resistant to the fundamentals of marketplace capitalism, despite being so predictable. Which begs the question, for whose benefit does this system operate? It’s clearly not for the benefit of women and their families.

Health care absurdities aside, the problem is large. In Philadelphia, 40-45% of all women of reproductive age live in a neighborhood without a delivery hospital. There are racial and ethnic disparities in maternal outcomes- maternal mortality as well as infant mortality. The United States has poor rates of both, especially considering that we spend more than any other country on health care, and $86 billion annually for maternal care, more than the expenditure for any other specialty. The US ranks 40th for maternal mortality behind other developed countries; we have shown no improvement in twenty years!

Despite setting a national goal in Healthy People 2010 of 4.3 deaths per 100,000 live births, the reality in 2010, the national average, is 13.3/100K. The rate in some rural and inner city areas is appalling- 20.5 in Georgia, 34.9 in Washington DC. For black women in New York City, the maternal mortality rate is 83.6, according to the City’s Department of Health. That’s plain old discrimination! African-American women are four times more likely to die due to complications of pregnancy than white women.

Poverty and poor maternal health increase the risk for premature babies. Prematurity increases the risk of mortality for both mother and child. The single most important factor for healthy babies is whether their mothers had adequate prenatal care. The Center for Disease Control and Prevention asserts that half of all maternal deaths in the US are preventable, but services are not located where women need them to be.

Feminists everywhere need to recognize that maternity care is yet another reproductive right in need of advocacy and protection.