@ Idaho hospital to stop L&D services

[wesleycrusher]

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This American Life ran a story earlier this month on Dr. Amelia Huntsberger, an OB-GYN in a rural town in northern Idaho. But for almost a year, she’s been fighting a losing battle, and realizing that she and her family might soon have to pull up stakes and leave.  www.thisamericanlife.org/792/when-to-leave



This weekend, it was announced that the hospital is stopping labor and delivery services, and that Dr. Huntsberger has decided to leave. 

Citing staffing issues and political climate, North Idaho hospital will no longer deliver babies

idahocapitalsun.com/2023/03/17/citing-staffing-issues-and-political-climate-north-idaho-hospital-will-no-longer-deliver-babies/

Now not only are OB-GYNs are leaving the state- the state can't recruit new doctors AND the state is stopping the maternal mortality review committee (I can only imagine to hide the impact). 

The impact is also being felt by the ER physicians who are having to pick up these emergency cases without specialized training. 


Boarder picture is that this is going to happen more, especially as new residents chose to not go states with these restrictive laws. 

www.beckershospitalreview.com/care-coordination/as-birth-rates-increase-ob-gyn-shortage-worsens.html

Residency matches for the first class of OB-GYN applicants post-Roe v. Wade will soon be announced. Preliminary data from the American Association of Medical Colleges shows that 2023 applications for the specialty have fallen from 2022, according to Roll Call.

Uncertainty about where and how to practice since Roe v. Wade was overturned may be a factor in the decline, Roll Call reports.

"A CQ Roll Call analysis found that 84 obstetrics and gynecology residency programs of 299, or 28 percent, accredited by the Accreditation Council for Graduate Medical Education are based in states or territories enforcing pre-viability bans on abortion," the outlet noted. "While regional applicant data is not available, in interviews some students expressed reluctance toward training in states with abortion bans that could affect their scope of medical training."

[Saudade]

This happened several years ago north of where I live, not due to politics but lack of providers. We're the closest OB services, which is two hours south the most populated town, on a curvy, two lane road.

One of my besties just matched to OB in Michigan. I'm so proud of her but also nervous for her future.

[wanderingback]

This has unfortunately been happening for awhile and it’s going to get worse. I trained in a big city and L&D floors were shutting down left and right and this was over 10 years ago.

Family medicine doctors do a lot of obstetrics in rural areas (some are credentialed to do csections) and even in some large cities. We really need to take a whole new approach to maternity care in this country. Many pregnancies and births can be managed by family medicine and midwifery. We need to take capitalism and making money out of health care. Unfortunately things are getting worse and not better.

[AJL]

Mar 20, 2023 9:49:33 GMT -5 wanderingback said:

This has unfortunately been happening for awhile and it’s going to get worse. I trained in a big city and L&D floors were shutting down left and right and this was over 10 years ago.

Family medicine doctors do a lot of obstetrics in rural areas (some are credentialed to do csections) and even in some large cities. We really need to take a whole new approach to maternity care in this country. Many pregnancies and births can be managed by family medicine and midwifery. We need to take capitalism and making money out of health care. Unfortunately things are getting worse and not better.

This right here. I wish our maternal health practices bolstered midwifery care to be an available option for more women. 

[NewOrleans]

I don’t mean to sound glib… Idaho and other states have repeatedly demonstrated they do not care about health (anti Medicaid expansion for years) and certainly not about women’s health or else we wouldn’t be here in the first place. So I predict Idaho will remain supremely unbothered by this.

[bronxgirl]

Mar 20, 2023 9:49:33 GMT -5 wanderingback said:

This has unfortunately been happening for awhile and it’s going to get worse. I trained in a big city and L&D floors were shutting down left and right and this was over 10 years ago.

Family medicine doctors do a lot of obstetrics in rural areas (some are credentialed to do csections) and even in some large cities. We really need to take a whole new approach to maternity care in this country. Many pregnancies and births can be managed by family medicine and midwifery. We need to take capitalism and making money out of health care. Unfortunately things are getting worse and not better.

Yes!! A thousand times yes.

[basilosaurus]

Mar 20, 2023 9:29:58 GMT -5 Saudade said:

This happened several years ago north of where I live, not due to politics but lack of providers. We're the closest OB services, which is two hours south the most populated town, on a curvy, two lane road.

One of my besties just matched to OB in Michigan. I'm so proud of her but also nervous for her future.

And, I'm guessing that curvy two lane road has ice and/or snow much of the year.

[mpm]

Mar 20, 2023 13:20:11 GMT -5 NewOrleans said:

I don’t mean to sound glib… Idaho and other states have repeatedly demonstrated they do not care about health (anti Medicaid expansion for years) and certainly not about women’s health or else we wouldn’t be here in the first place. So I predict Idaho will remain supremely unbothered by this.

That’s really not a fair assertion at all. As a citizen of another state that hasn’t expanded Medicaid, a better description is more along the lines of a hostage situation.

[Michelle]

Mar 21, 2023 4:59:50 GMT -5 mpm said:

Mar 20, 2023 13:20:11 GMT -5 NewOrleans said:

I don’t mean to sound glib… Idaho and other states have repeatedly demonstrated they do not care about health (anti Medicaid expansion for years) and certainly not about women’s health or else we wouldn’t be here in the first place. So I predict Idaho will remain supremely unbothered by this.

That’s really not a fair assertion at all. As a citizen of another state that hasn’t expanded Medicaid, a better description is more along the lines of a hostage situation.

Nodding from Texas.

[underwaterrhymes]

I’m just so angry. This is what happens when you legislate the bodies of people with uteruses. This is what happens when you specifically design healthcare to be inaccessible for huge segments of the population. This is why we have the worst maternal and infant mortality rates in the western world (and they’re only going to get worse.)

[EvieEthelGarland]

My family vacationed in Idaho last summer (right after Dobbs came down)and 3 separate times it came up in conversation with other women about how pissed off they are. A hostess at a restaurant in Boise. A manager of bar in a resort area near CdA. A barista in Sandpont. Roles that if they were wrong about where I fell on this issue, they could be in trouble, but they did not care. The anger was palpable. I really hope they're showing up to vote and that the people who are just as angry but not as vocal do as well. Sadly, I think the whole redoubt movement has taken over too much.

[NewOrleans]

Mar 21, 2023 4:59:50 GMT -5 mpm said:

Mar 20, 2023 13:20:11 GMT -5 NewOrleans said:

I don’t mean to sound glib… Idaho and other states have repeatedly demonstrated they do not care about health (anti Medicaid expansion for years) and certainly not about women’s health or else we wouldn’t be here in the first place. So I predict Idaho will remain supremely unbothered by this.

That’s really not a fair assertion at all. As a citizen of another state that hasn’t expanded Medicaid, a better description is more along the lines of a hostage situation.

 Its Republicans outnumber its Democrats vastly. It has not gone for a Democrat since 1960.  I’m not sure how else to refer to it.  

Naming a state by its name does not dismiss that some states are suppressed states, that Republican governments are extremist organizations, or that boots on the ground resist in those states. Idaho as a legal entity does not prioritize public health outcomes.  

[jeaniebueller]

Michigan has extremely liberal reproductive freedom and in my rural community, our hospital system cannot recruit doctors. I think it’s a combo of the way these hospital systems are run that drive doctors away from them, pandemic, related issues, and other concerns as well. I don’t think it’s fair or accurate to act as if only states with limited reproductive access are facing this problem. My kids and I currently have no primary care doctor right now because ours just left, and the other two medical professionals in the practice are booking new patients out to early 2024. The medical system overall seems to be crashing everywhere.

[underwaterrhymes]

Mar 21, 2023 21:59:08 GMT -5 jeaniebueller said:

Michigan has extremely liberal reproductive freedom and in my rural community, our hospital system cannot recruit doctors. I think it’s a combo of the way these hospital systems are run that drive doctors away from them, pandemic, related issues, and other concerns as well. I don’t think it’s fair or accurate to act as if only states with limited reproductive access are facing this problem. My kids and I currently have no primary care doctor right now because ours just left, and the other two medical professionals in the practice are booking new patients out to early 2024. The medical system overall seems to be crashing everywhere.

While that is true, abortion restrictions and their impact on doctors are specifically mentioned in the article:

“Idaho has one of the most restrictive abortion bans in the country, with affirmative defenses in court only for documented instances of rape, incest or to save the pregnant person’s life. Physicians are subject to felony charges and the revocation of their medical license for violating the statute, which the Idaho Supreme Court determined is constitutional in January.

“The Idaho Legislature continues to introduce and pass bills that criminalize physicians for medical care nationally recognized as the standard of care,” the hospital’s news release said. “Consequences for Idaho physicians providing the standard of care may include civil litigation and criminal prosecution, leading to jail time or fines.”

Dr. Amelia Huntsberger, an obstetrician-gynecologist at Bonner General Health, said in an email to States Newsroom that she will soon leave the hospital and the state because of the abortion laws as well as the Idaho Legislature’s decision not to continue the state’s maternal mortality review committee.”

[Bad Dingo]

Connecticut is attempting to combat similar issues portal.ct.gov/Office-of-the-Governor/News/Press-Releases/2023/03-2023/Governor-Lamont-Proposes-Legislation-Expanding-Access-To-Maternal-Health.

[pixy0stix]

The problem with whole states having their healthcare system collapse is that those people don't just stop seeking care. Neighboring states with less restrictive laws receive those patients, which puts a strain on their capacities, and could mean the collapse of a whole other system. We're seeing that here in CO with abortion services. There are not enough providers to give the care to the people who live here, let alone those coming in from other states.

And while I can understand the "well those women deserve to die from their choices", I just can't get there. The children are also dying. Wanted children that might have had a chance at life if they had received care as they were being born, or conditions were caught before birth.

[sonrisa]

Mar 22, 2023 8:57:45 GMT -5 pixy0stix said:

The problem with whole states having their healthcare system collapse is that those people don't just stop seeking care. ...

Yes.

The other problem is some do stop seeking care. And instead of getting timely preventative interventions, when care happens, it is coming after thing become dire. (and some of that delayed care is also going out of state).

[sonrisa]

I have no time for "they brought this on themselves by voting for these legislators."

Even if this applies to some, there is still the 1 in 3 voters who voted for the opposition. Not every pregnant person can vote. Not everyone is a citizen. Not everyone is franchised. Not everyone is over age 18.

And as pixy said, none of the babies brought this on. 

[lilac05]

Mar 22, 2023 8:57:45 GMT -5 pixy0stix said:

The problem with whole states having their healthcare system collapse is that those people don't just stop seeking care. Neighboring states with less restrictive laws receive those patients, which puts a strain on their capacities, and could mean the collapse of a whole other system. We're seeing that here in CO with abortion services. There are not enough providers to give the care to the people who live here, let alone those coming in from other states.

And while I can understand the "well those women deserve to die from their choices", I just can't get there. The children are also dying. Wanted children that might have had a chance at life if they had received care as they were being born, or conditions were caught before birth.

Yes to all of this! Not to mention that no matter how RED a state is, there are still people who disagree with all of this living in these states. Some are stuck there for any number of reasons, some have decided that they want to stay and fight to make things better…or at least less awful. That’s where we’re at in Iowa right now, and why we haven’t left. We are privileged in nearly every way. We see it as our responsibility (right now) to stay and fight for those whose lives are being destroyed by legislation. We’re organizing groups at the local level to change school boards, call out hypocrisy, etc. We’re not too far gone…yet. But if everyone who COULD move left the state, there’d be no chance of improvement for those who cannot move. We used to be a respectable state, but our current Governor is destroying it. Quickly.

It’s a sore spot for many when people (here and otherwise) talk about states as a collective. By the numbers, it’s highly likely that there are more conservatives in California than Iowa…and more Democrats in Texas than Massachusetts. And in Iowa, we only slightly lean red, although the current legislature would suggest otherwise because they’re absolutely drunk on power.

ETA: Out of curiosity, I looked it up…there are nearly twice as many registered Republicans in California than the population of the entire state of Iowa.

[katespade]

Mar 22, 2023 10:09:20 GMT -5 sonrisa said:

I have no time for "they brought this on themselves by voting for these legislators."

Even if this applies to some, there is still the 1 in 3 voters who voted for the opposition. Not every pregnant person can vote. Not everyone is a citizen. Not everyone is franchised. Not everyone is over age 18. And as pixy said, none of the babies brought this on. 

YES. And it's rarely as simple as "move to a different state." There are so, so many reasons why that isn't possible for most people, especially in a rural state like Idaho.

[bugandbibs]

Provider shortage is such a huge problem throughout health care. There are a lot of factors and the burnout from those of us working insane caseloads is very real. It's really hard to make decisions about specialty and where to practice while balancing your own personal needs. I don't blame people for going into more lucrative specialties or choosing work environments where they will be better supported. Something that I have come to realize over the years that my humanity and ethics are independent from those of my patients. How I treat them, is based more on who I am than who they are.

In this particular case, it feels extra demoralizing that a specialty that is larger focused on women is deemed less than and therefore less appealing. Certified midwives working within the hospital system are common in my region, but I suspect that a big part of that is that they are fully covered as providers under Medicare here. In addition to having it be something that is licensed and regulated.