WNC Labor And Delivery Closures Leave A Gap In Women’s Healthcare

Dec 12, 2019


  Last week, the doors closed on Erlanger Western Carolina Hospital’s Labor and Delivery Unit in Murphy. Here’s what the closure means for the region.

The closure was announced abruptly last month, as the number of births at the hospital had been declining for at least the last 5 years.  

Mayor Rick Ramsey of Murphy says he understands the decision because it was based solely on numbers. 

“There’s not enough predictable births to sustain and maintain the staff and the cost for doing so,” says Ramsey. 

Erlanger, a Chattanooga-based health system, purchased Murphy Medical Center in 2017. It’s now the only nonprofit hospital west of Asheville and was the westernmost labor and delivery unit. Now the closest maternity services in North Carolina are over 60 miles away in Sylva, though some hospitals in Georgia and Tennessee are closer as both states border Cherokee County.

Ramsey explains that about half of women in the county went to other hospitals to deliver, so he isn’t concerned about a lack of access to healthcare.

“We’re scoring well for what is needed for additional industries to come in,” says Ramsey. 

The closure is part of a national trend of labor and delivery units closing. Western North Carolina has certainly felt it says Dr. Bryan Hodge.

“With Erlanger closing in the past 5 years we have had 6 labor decks close,” says Hodge.  

Hodge is director of Rural Health Initiatives at the Mountain Area Health Education Center or MAHEC. The regional organization recruits and trains medical practitioners to rural areas. Hodge is very concerned about what the closure means for Western North Carolina. 

“I do think the services were more essential there then a lot of our closures in other regions,” says Hodge. 

Hospitals in nearby Georgia and Tennessee have become an alternative for mothers.  More babies being born out of state isn’t good, says Hodge. 

“It’s not close enough. I think that is further distance and that there are issues going across state lines,” explains Hodge. He says one example is the differences in Medicaid between states. 

 Erlanger has been focused on recruiting primary care doctors. Hodge says that is important but  so are women’s health services. 

“I think it’s pretty well known in the literature at this point that if a woman is traveling more than 30 miles to give birth than the outcomes are worse,” says Hodge. 

Hodge says that there are 4,000 women of child bearing age in Cherokee County and another 2,000 in Graham and Clay County - they also relied on Erlanger’s maternity services. 

Stephanie Johnson is the director of the Clay County Health Department.

“You know if you can’t bring in enough revenue to pay your doctors and staff to be there all the time then I get it. It’s a business,” says Johnson. “But looking at it from the human perspective it’s never easy to hear.” 

 Johnson says the county depends on the medical care in Murphy since there is no hospital in Clay County. Cherokee County also operated the maternal programs for Clay County mothers because all the OB/GYNs were there. Johnson is working with Erlanger and the Cherokee County Health Department to figure out how services will work in the future. 

“As a public health service we really need to start looking at those gaps and figure out what we can do so that our families are taken care of,” says Johnson.  

One of the main reasons cited for the lack of babies being born at Erlanger, is the advancing age of the region’s residents. 

Sara Jane Melton is with the Area Agency on Aging. She says all of the westernmost counties have more people over the age of 65 than under 17.

“So that has been true in Cherokee for 5 years or longer but now that’s true for the whole region,” says Melton.  

As the region ages hospitals that were previously centered on family care must change says Melton.  Even so, she adds the local healthcare system isn’t prepared to take care of the elderly as they age. 

“We’re behind the 8 ball now, regarding services for older adults,” explains Melton. 

Dr. Bryan Hodge sums it up by looking at these closures of women’s health services as a systemic issue: 

 “We’re going to have to address these challenges more aggressively in upcoming years if we really care about our more marginalized populations and our more rural communities that have fewer resources.” 

Erlanger will close its OB/GYN offices at the end of the month.