Open letter to the Southwest Health System Board of Directors,
It was with deep alarm that I learned of SHS’s plan to “temporarily” close the Family Birthing Center at Southwest Memorial Hospital. As an Internal Medicine physician, a proud resident of Cortez, and a new mother who had the privilege of delivering my son at the Birthing Center last year, I can say that this decision constitutes nothing short of a public health emergency.
We are living in a time of increasing maternal mortality all across the country, and most notably in “maternity care deserts.” Women and infants in rural areas, such as ours, already suffer higher rates of pregnancy complications. One study of a maternity care desert in Louisiana showed that women were more than three times as likely to die during pregnancy and the postpartum period compared with women in areas with greater access. Closing the SHS Birthing Center will place Montezuma County’s pregnant women, young mothers and infants at an unacceptably increased risk of harm, including death.
SHS claims it is not shutting down all obstetric services. As the public relations representative said in a phone call with a concerned community member, it will still offer perinatal services, women will “just have to go elsewhere for delivery.“ This is, at best, a short-sighted view of the likely impacts of this change, and at worst is deception.
SHS said that recruitment of talented OB/Gyns is challenging, but this would become exponentially more so if the job description doesn’t include actually delivering babies. There is no reason to believe that exceptionally talented physicians, such as Drs. Kaplan and Schmitt, would remain here in Cortez under this new arrangement, or that we would be able to replace them should they make the very reasonable decision to leave. The closing of the Family Birthing Center is very likely the beginning of the end of all perinatal – and possibly women’s health – services at SHS.
The SHS press release cited a “decline” in birth volume at SHS. Numbers provided to me showed these to actually be relatively consistent – 163, 147, 149, 166 and 140 for the years 2018 to 2022. They are on track to deliver 73 babies by the end of June. While it is true that around 200 births per year helps an obstetric unit remain viable, Dr. Katy Kozhimannil, who conducts research on maternity care deserts and is specifically referenced in SHS’s own press release, said:
“Of all the folks that we surveyed, about a third of them were still operating, even though they had fewer than 200 births a year,” Kozhimannil said. “We asked why, and they said, ‘because our community needs it.’ ”
In other words, if a hospital system and a community are willing to prioritize the health of women and infants, this problem can be solved.
Unfortunately, SHS has not shown this will. The Birthing Center staff learned about this decision on June 6, three weeks before the planned closure. They were not consulted. The community was not informed. No plans have been made for the transition of care of women who are currently pregnant. Given this timeline, how is it possible for the board to say that the decision was made with “careful consideration?”
On behalf of our community, I insist that the SHS Board reconsider this dangerous decision. I have no doubt that keeping a maternity care unit financially viable is challenging, but there has been no attempt to involve the staff or the community in finding solutions. We are willing to act to keep the Birthing Center open, but in order to do so, we need the closure to be delayed for long enough to allow for community discussion and to make safe transition plans for our mothers who are currently pregnant. Moreover, we need the board to act with a sense of transparency and collaboration that we have not yet seen.
I am proud that I will be able to tell my son that he was born here in Cortez, in the same town where I met his father, where we got married and where we have built a life. All parents in our community have a right to the same: a safe delivery, close to home and in the community they love.
Eleanor Emery, MD, is an Internal Medicine physician and resident of Cortez.
