The hospital where this mom-to-be plans to deliver her first child is more than an hour from her home | CNN (2024)


Mom-to-be Stephanie Zuroski hopes she recognizes the signs of labor quickly, because the hospital where she plans to deliver her first child is more than an hour from her home in rural Elk County, Pennsylvania.

Elk County is about 2½ hours outside Pittsburgh, nestled at the edge of the Allegheny National Forest. Zuroski grew up on a farm and is familiar with the tradeoffs that come with rural living.

“I am accustomed to driving to get the things that I need,” said Zuroski, 32.

What she didn’t expect was the lack of labor and delivery units in the county, which means she’ll have to drive out-of-state to give birth in a hospital.

“When I started looking into pregnancy and [obstetrician] care, I was shocked local hospitals weren’t delivering babies,” Zuroski said.

Traffic passes the publicly owned Greenwood Leflore Hospital, in Greenwood, Miss., Friday, Oct. 21, 2022. The hospital announced the permanent closure of its labor and delivery unit, saying it can't pay competitive wages to nurses. The closure means the area's women will need to travel about 45 minutes to give birth at a hospital, and without focused hospital support, the city's only OB/GYN clinic could struggle to provide maternity care. (AP Photo/Rogelio V. Solis) Rogelio V. Solis/AP Related article Hospitals in a 10th of US counties have lost childbirth units over the past five years, according to a new analysis

In February, the Penn Highlands Healthcare hospital system announced that it was “realigning services” and moving labor and delivery services from Penn Highlands Elk— the only hospital in the county —to its sister hospital Penn Highlands DuBois, about 30 miles south in Clearfield County, on May 1. The shift limits maternal health care options in the area, and could raise the risk of people delivering in riskier conditions — even at home or in their cars.

New and expecting mothers would still be able to get scans, tests and exams at Penn Highlands Elk, but they will no longer be able to deliver there.

“For Penn Highlands Healthcare, this transition is about quality and reducing risk and not finances,” the health system said in awritten response to CNN.

The hospital in DuBois has the only neonatal intensive care unit within 100 miles, according to Penn Highlands Healthcare, and is staffed to handle high-risk deliveries.

“The transition is designed to offer a higher level of care for mothers and newborns,” the health system said in anews release.

The hospital where this mom-to-be plans to deliver her first child is more than an hour from her home | CNN (2)

Stephanie Zuroski and her pet goat Cotton announced their pregnancies together. Cotton has since given birth to quadruplets.

It added that the declining number of births at Penn Highlands Elk was another factor in the decision.

“The number of deliveries is declining in Elk County. The number of births decreased from 233 in 2013 to 170 in 2023. Approximately 100 patients from St. Marys and the surrounding communities have been delivering at Penn Highlands DuBois each year,” Penn Highlands Healthcare told CNN.

Maternity care deserts

The closure of the labor and delivery unit leaves five counties with limited access to a labor and delivery unit.Two of the counties, Forest and Cameron, are considered by maternal health nonprofit March of Dimes to be maternity care deserts:areas withoutobstetric providersand without a hospital or a birth center offering obstetric care.

“This is a devastating thing that is happening. Women are struggling to have access before, during and after their pregnancy journey,” said Barbara Roth, March of Dimes executive director of market impact in western Pennsylvania.

“The farther a woman travels to receive maternity care, the greater the risk of maternal morbidity and adverse infant outcomes, such as stillbirth and NICU admission. Furthermore, longer travel distances to care can cause financial strain on families and increased prenatal stress and anxiety,” March of Dimes says in areport. “The distance a woman must travel to access care becomes a critical factor during pregnancy, at the time of birth, and in the case of emergencies. Nationwide closures of birthing hospitals have contributed to increased distance and travel time to care, especially in rural areas.”

Roth said the nonprofit advocates for the expansion of access “to doulas, midwives and telehealth” and held an advocacy day at the Pennsylvania Capitol in March to raise awareness about maternal and infant health care concerns such as these access issues.

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“In the state of Pennsylvania, women living in counties with the highest travel time could travel up to 42.7 miles, and that’s about 57 minutes on average … to reach their nearest birthing hospitals,” Roth said.

Statewide, March of Dimes says, about7.5% of countiesin Pennsylvania are maternity care deserts, and about 12% of women don’t have access to a birth hospital within 30 minutes of them.

Certified nurse midwife Lauren Narbey said the situation in Elk County is a familiar one.

When WVU Medicine Uniontown Hospital in Fayette Countyclosed its birthing center in 2019, she saw “a huge increase in the number of patients” who drove 45 minutes or more to deliver their babies at Jefferson Hospital in Allegheny County, Pennsylvania, where she has worked since 2018.

“It’s a very high-risk area, not a lot of health care at all available,” Narbey said of Fayette County, which is on the border with West Virginia. “So patients are now having to drive sometimes two hours to get to Labor and Delivery.”

Uniontown Hospital has since announced that it is re-establishing its obstetric services.

At her hospital, Narbey says, she has seen patients come in to deliver without any prenatal care, simply because of the distance to the hospital and the lack of resources or support at home — especially people with multiple children. Many of her patients ask to schedule inductions so they can avoid making the trek while in labor, she said.

“This patient population really wants scheduled inductions at 39 weeks, which is the earliest we can offer without any kind of really risky complication necessitating delivery before then. And they really do want that, because they want to be able to plan the trip. They want to be able to plan child care. They don’t want to have their baby in the car on the way. So I’ve seen a huge uptick in people wanting an induction,” she said.

Emily McGahey, a midwife and the clinical director atThe Midwife Centerin Pittsburgh, said birth centers like hers also have clients who do their best to plan.

The hospital where this mom-to-be plans to deliver her first child is more than an hour from her home | CNN (4)

The Clarion River flows through Elk County.

“Sometimes, our families will arrange a time to come in and have a baby, or sometimes, they will labor and then maybe move to a closer family member or friend’s home or get a hotel room closer by,” she said, adding that clients at the center are typically discharged hours after birth and return for a checkup within the first 72 hours.

And that’s just the patients who are able to plan ahead; many don’t make it in time for their deliveries.

“That happens a lot for us,” Narbey said. “I mean, like a few times a month that patients will have babies at home or in the car and then they’ll just bring them in the ambulance, and then we just cross our fingers that they’re not hemorrhaging when they get here because their placenta is still inside.”

Seeking solutions

In Elk County, Nick Burdick, manager of the St. Marys Area Ambulance service, is preparing for the possibility that his team will be called upon to deliver babies more frequently and is working with Penn Highlands Elk to get up to speed on the latest labor and delivery technology.

“We are certainly all trained in labor and delivery, although it’s not something that we experience often. But with the news of this unit and service closing in our local hospital, we’re absolutely taking the opportunity to increase our training and get more experience in labor and delivery and neonatal care,” Burdick said. “So we will be working with Penn Highlands Elk in taking labor and delivery training as well as advanced neonatal life support, so they are willing and definitely helping accommodate us in their transition and giving us the resources and the education to be able to care for the community.”

CNN Related article Maternity units are closing across America, forcing expectant mothers to hit the road

Zack Pontious’pregnant sister-in-law was due May 1, the day the unit at Penn Highlands Elk is set to close. But the baby came early, saving her the 45-minute drive to Penn Highlands DuBois, said Pontious,a member of theRidgwayBorough Council in Elk County.

The new uncle says the council is limited as to what it can do to replace labor and delivery services in the area.

“Boroughs provide services like trash pickup and snowplow. We’re not really in the business of providing health care,” he said.

After Penn Highlands’ announcement, he and other local officials and business owners formed a group to with state representatives and come up with ways to support and incentivize the health care system to maintain its services in Elk County.

Despite their efforts, the system is still moving forward with its plan, frustrating Pontious, who moved to Elk County to be closer to family as he and his wife plan to start their own.

“My wife and I moved here, and she never thought that this was a concern that we would have to have: that we’d have to be fighting for women’s services to be left in – not even our town – in our county,” he said.

In neighboring Cameron County, Commissioner Joshua Zucal said officials are also exploring options to offset the closure of Penn Highlands Elk’s labor and delivery unit, such as midwives to help with home births.

“Cameron County was never notified or brought into the loop that this was occurring. It was just something that we had to hear through the news of it happening,” he said.

Zucal said it’s not just maternal health care that is taking a hit in rural Pennsylvania;some local doctors’ and dental offices have also closed or relocated, and it’s hard for Cameron County to attract enough people to work for emergency response teams in the area.

“There are the basic needs communities must have, and we need to have access. It’s not that we have lost all access, but you can see pieces of the puzzle falling apart,” he said.

The hospital where this mom-to-be plans to deliver her first child is more than an hour from her home | CNN (6)

The Meadow Room is one of the three birth rooms at the Midwife Center, the only freestanding birth center in western Pennsylvania. Clients come from central Pennsylvania, West Virginia and Ohio to deliver their babies at the center.

The county commissioner said he is focusing on the solutions to try to remain optimistic.

“What are the things that we can implement to still have a thriving community, though there are challenges? How can we still focus on the quality of life that a rural community can offer? And then also the health and wellness aspects, that if you’re a healthy person, the amount of care that you’re going to need is much less than somebody who’s unhealthy. So if we can create healthy communities, we won’t need such a crutch and be so reliant on these organizations that choose to do things such as closing maternity,” he said. “So we just need to figure out solutions to take care of our own.”

Many people think a birth, or birthing, center is the perfect solution for an area like Elk County. These centers – where people with low-risk pregnancies can deliver in ahome-like facility,with more autonomy over the experience – are designed to “provide routine care and initiate emergency procedures” and must be positioned close enough to a hospital where women can get c-sections if they need, according to theAmerican Association of Birth Centers.

“I think that’s a really valuable resource that our community should look into,” Zuroski said. “It’s definitely a resource that I would consider using in the future.”

Narbey, acknowledging her perspective as a midwife, also agrees.

“This is my biased opinion. I think midwives are part of the solution. Most women are low-risk, and we could staff a birthing center starting with three midwives, which is cheaper than an obstetrician, and midwives tend to be really good at connecting with their communities and meeting people in a culturally sensitive, appropriate trauma-informed perspective,” she said, adding that communities in Alaska, Montana and South Dakota are turning to this model as a solution.

Health care by ZIP code

Health care wasn’t at the front of Zuroski’s mind when she moved to Elk County in her mid-20s. Now, the the environmental engineer said she feels a deep connection to the community.

It’s vibrant and green in the spring and summer and awash with fall color in the cooler months, and Zuroski says she was drawn to the area by the sky-scraping trees and the “beautiful little mountain streams that hold wild trout populations.”

“I’m willing to compromise and give up some things in order to stay here and live where I’m happy,” she said.

For now, Zuroski makes a 45-minute commute every four weeks to her appointments with a certified nurse midwife in Bradford, Pennsylvania, close to the New York state line.

And when it’s time for the baby to come in August, she plans to pack up and head to Olean, New York, now one of the closest hospitals to her with a maternity ward.

“Traveling far while in labor will be uncomfortable,” she said.

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McGahey says it is time for communities to step up to ensure that maternal health care remains accessible to families.

“I think on a larger community level, we need to be advocating for us as a society to figure out how we value maternity care in our country because it’s not valued,” she said. “As we can see, all of these maternity care deserts in our counties, across our state and the country, and this is leaving hundreds of thousands of families without care.

“Where you live and where you choose to raise your family shouldn’t affect the quality of health care that you receive,” McGahey said. “And I think that’s the biggest issue right now is how we continue to show families support and take good care of them.”

Narbey agrees. “In some cases, it can be a life-and-death situation, and that should never be the case. But unfortunately, your ZIP code determines more about your health outcomes than any other factor.”

The hospital where this mom-to-be plans to deliver her first child is more than an hour from her home | CNN (2024)


The hospital where this mom-to-be plans to deliver her first child is more than an hour from her home | CNN? ›

Mom-to-be Stephanie Zuroski hopes she recognizes the signs of labor quickly, because the hospital where she plans to deliver her first child is more than an hour from her home in rural Elk County, Pennsylvania. Elk County is about 2½ hours outside Pittsburgh, nestled at the edge of the Allegheny National Forest.

What is the birth part of the hospital called? ›

Giving Birth at a Hospital. Traditional hospital births are still the most common option. This means the mother-to-be moves from a labor room to a delivery room and then, after the birth, to a semiprivate room.

How to choose a maternity hospital? ›

Your GP will tell you which hospitals have maternity services in your area, and you can choose which one to use. You can ask to use a different hospital. If your GP will not refer you to the hospital you choose, you can refer yourself. Look on the hospital's website or ask its maternity team for the self-referral form.

Where are newborns kept in the hospital? ›

Afterward, your newborn goes to the well-baby nursery briefly – your partner may be able to go with them – while you head to the recovery room. In the nursery, their vital signs are taken, and they are weighed and measured.

What is the labour room? ›

The Delivery Suite or the Labour Room is a place where childbirth takes place. It is also termed as 'Birthing Unit'. This unit provides facilities for safe prenatal care, delivery and immediate postnatal care of mothers and infants. It is also called as 'LDR' (Labour, Delivery and Resuscitation).

What hospital delivers the most babies? ›

U.S. hospitals with the most births
1Northside Hospital AtlantaAtlanta
2Orlando Health Winnie Palmer Hospital for Women and BabiesOrlando
3Northwestern Memorial HospitalChicago
4The Womans Hospital of TexasHouston
6 more rows
Apr 25, 2024

Which hospital is best for baby delivery? ›

Best Maternity Hospitals in Bangalore - Book Appointment Online
  • Kangaroo Care Clinic. ...
  • Kangaroo Care Fertility Center. ...
  • Apollo Cradle & Childrens Hospital. ...
  • Hope Hospital. ...
  • Revive Hospital. ...
  • Rainbow Childrens Hospital & Birthright By Rainbow. ...
  • Jayadev Memorial Rashtrotthana Hospital and Research Centre. ...
  • Dr Shilpa Fertility Clinic.

What is the busiest maternity hospital? ›

In crowded Manila, the capital of the Philippines, Anita Rani follows the lives of three different women and visits a hospital where up to 100 babies are born each day. The head nurse in Manila's busiest maternity ward estimates that she has delivered 200,000 babies during her career.

Can you choose how you want to deliver your baby? ›

Yes, you can usually choose how and where you give birth. The type of birth you have will depend on: your preferences. your and your baby's health.

Is it more expensive to have a baby in the hospital or at home? ›

Giving birth in a hospital is usually the most expensive cost associated with childbirth. You'll also need to spend money on other things.

Do they take your baby away after birth? ›

Healthy babies born in a vagin*l delivery are usually able to stay with the mother. In many hospitals, immediate newborn assessments include weight, length, and medicines. Even the first bath is done right in your room. As quickly as possible, a new baby is placed in your arms.

Is it legal to give birth in the US? ›

Is it legal to give birth in the United States of America? Yes, giving birth in the United States, also known as Birthright Citizenship or jus soli, is legal. It is a right guaranteed under the Fourteenth Amendment of the U.S. Constitution.

Do hospitals bathe newborns? ›

While most institutions used to bathe babies within an hour or two of birth, many are changing their policies. The World Health Organization (WHO) recommends delaying baby's first bath until 24 hours after birth—or waiting at least 6 hours if a full day isn't possible for cultural reasons.

What are the 7 cleans during delivery? ›

There are a range of specific behaviours that fall within this definition of clean birthing practices, including: clean hands of the birth attendant, clean delivery surface, clean perineum, cutting of the umbilical cord using a clean instrument; clean cord tie; and clean cord care [10, 11].

Are men allowed in the labor room? ›

Men may give active assistance during childbirth by simply being present during his wife's labor or by coaching during childbirth. Many women find their partners' presence in the delivery room to be comforting.

Who is in the room during delivery? ›

Davis adds that you are typically allowed to have one support person in addition to a partner. While some women will choose to have a doula or labor coach there for support, others might invite a parent or additional family member. Regardless of who you invite into the delivery room, Dr.

What is the labor part of the hospital called? ›

A labor and delivery (L&D) department in a hospital, sometimes referred to as the obstetrics department, is a specialized unit that provides care to pregnant individuals during labor, childbirth, and the immediate postpartum period.

What is the baby department in a hospital called? ›

The Neonatal Intensive Care Unit (NICU)

What is the baby side of the hospital called? ›

The nursery, the newborn nursery, or the mother-baby unit. Or the neonatal intensive care unit, the special care nursery, or the NICU. We called the baby room the nursery.

What do you call the room where you give birth? ›

The labor room is one of the most versatile rooms in a hospital. It is called a labor, delivery, and recovery room (LDR). This is the type of room that some hospitals and almost all birth centers use for their care.


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