North Shore Hospital Board’s decision to cease planned local deliveries brings me great sadness. It’s been my joy and privilege to attend dozens of births at our local hospital. My sons were born here. Delivering babies is integral to the full spectrum “cradle to grave” care ideal that made me choose family medicine as career and rural Minnesota as home. The local delivery option, though not available to all, has been a valued community resource. There has been a wellspring of sincere concern and heartfelt public comment in the past week. I share in the grieving. We are losing something important.
This agonizing decision for the board is unavoidable at this time and in this place. For the past two decades, my partners at Sawtooth Mountain Clinic and I have been advocating for local birth. The world of obstetrics and medical liability has shifted under us. The hospital board has supported the local deliveries though the numbers have dwindled and the staff training costs are high.
Our practice has been to discuss risks and benefits with low risk patients and offer the option to deliver here. This practice is no longer acceptable in a world that has become increasingly risk averse. The actual risks have not changed.
Frustratingly, ideas of community value, best judgment, patient choice or decades of successful outcomes are no longer relevant discussion points. To be insurable for planned deliveries after July 1st, the hospital has to meet a standard of care requiring C-section availability within 30 minutes. The staffing required to do that is far out of the reach of a community this size. While we can’t provide C-sections, we can and will continue to provide excellent emergency delivery services for babies that just won’t wait. We will accompany women who can be safely transferred in early labor to another facility. We will continue to offer prenatal and postnatal care at the clinic. Both North Shore Hospital and Sawtooth Mountain Clinic are committed to continuing to provide high quality care for the health and safety of Cook County and visiting mothers and babies.
We face many challenges living in this relatively isolated community. Historically, Cook County residents have come up with creative solutions to meet those challenges. Solutions as unique as this place we love. This is an opportunity. There is much we can do as a community to support pregnant women and their families even as we lose planned local deliveries. We can work to strengthen relationships with delivering providers and simplify the transfer of care. We could help with transportation barriers and temporary housing. We could strengthen doula services, prenatal care and childbirth education. We can partner with other rural communities facing similar struggles and find out what other ideas are out there.
We invite and need community members of all ages to be part of this vision of improving and expanding services for growing families. A work session for what we are calling Birth Partners is planned for Wednesday, Feb. 11 from 5-7 p.m. in the basement of the First Congregational Church. See page A11 for details. Please join us with your passion and ideas. There is work to be done.
Jenny Delfs, MD
Sawtooth Mountain Clinic physician
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