Despite federal law that requires every emergency room in the U.S. to treat women in labor, some women are still turned away at rural facilities or treated at hospitals that lack an obstetrics specialist.
Federal investigation records show that least 20 rural hospitals were in violation of the Emergency Medical Treatment and Labor Act over the last five years, according to an article from ProPublica and the Louisville Courier-Journal. Some of these facilities also refuse to help women in labor transfer to a different location for treatment.
Experts say the protections in EMTALA haven’t improved rural access to obstetric care. “The availability of OB services in rural areas has steadily declined since the beginning of EMTALA in 1985,” Todd Taylor, M.D., an emergency physician and EMTALA compliance consultant, told the publication.
ProPublica’s dive into federal records was prompted by a recent case at Jewish Hospital Shelbyville, a 42-bed facility under KentuckyOne Health, the state’s largest health system. A young woman came to the emergency department to deliver her baby, but the hospital’s obstetrics department had been closed for close to a decade. Instead, she was turned away, and was taken by ambulance to a different hospital more than 20 miles away to give birth, according to the article.
Representatives at the hospital told the publications that it has the equipment and personnel to provide obstetric care, but that a baby hasn’t been delivered at the hospital since 2014.
Rural healthcare is in dire financial straights, with as many as 13% of rural hospitals vulnerable to closure. Many facilities are struggling to adapt to new technological demands. However, rural facilities are the main providers to certain patient populations, as a fifth of Americans live in rural areas.