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That sounds outrageous, but we don't really know all the details with that, either. It may not be a situation of the local OBs being so overwhelmed. It may be something else, like her insurance coverage, she wanted something special, some other issue. That's the problem with these articles.
Yeah, it's always possible (and likely) that big pieces of the story are missing, but my gut is still telling me that there's a real problem of accessibility that needs to be addressed. Inaccessible prenatal care is a public health issue.
Lone among developed western nations the United States had this health care concept of a major hospital "on every corner" so to speak.
In other nations such as France you may have a hospital serving a small rural village or whatever, or it maybe nothing more than what we would call a clinic.
However the healthcare system in France simply will pay all associated costs involved in transporting a patient to major hospital or wherever so he/she can receive care required.
If a woman's pregnancy is deemed high risk, she will be moved long before due date from her rural village (along with one or more family members if necessary), to the closest major hospital. There she will remain until well after delivery when it is determined both mother and infant are well enough to return home. The state healthcare picks up nearly if not all of the entire tab.
Does this cost money? Sure, but far less than building and staffing major hospitals that largely sit under utilized.
I don't believe you work in health care, do you? I believe you are an educator. Yet you seem to know just how an OB unit should be run.
The closed hospital had an average of 500 births a year, according to the stats I found. That would mean ~15 twin births annually, on average. Obviously, it has to be an even number, so say 14 or 16. That is barely more than one set of twins a month! There's a big difference between "rare" (a term I did not use), once a month, and "frequent". Frequent would give the staff taking care of these patients, particularly the preemie babies, better skills. Sometimes it is better to travel some distance to make ensure the best results possible. Here are some stats on twins: https://www.verywellfamily.com/multi...t-data-2447119 If, of 16 twins born annually, about 9 will be low-birth weight. That is very few babies. Care always improves with more experience. Babies as little as the woman's in the OP need a Level III, maybe even Level IV nursery: https://rockymountainhospitalforchil...re-unit-levels
It doesn't really matter what you consider rare, again, a term I did not use.
The hospital that closed was a for-profit hospital. But it may surprise you to know that most hospitals in the US are either government (excluding the VA hospitals) or private non-profit. "According to the AHA, about 18 percent of U.S. hospitals are private, for-profit hospitals, while 23 percent are owned by state and local governments. The rest are private, nonprofit facilities." Did You Know: For-Profit Versus Nonprofit Hospitals | Health Net Broker Pulse
I'm not sure how we got to the hostile phase? Was I being disrespectful to you or something? I thought we were just talking, exchanging ideas here. Can we bring this down a notch or two? LOL
I didn't say most hospitals are for profit? I said this one closed because it was. But even non profit hospitals have to consider money because of how they are funded. That's fine! It is what it is.
I'm not sure why you are giving the rate of twin births here because I never argued with you about that? I used the numbers you posted in my own response.
And I never said twins were "frequent", just common enough IMO that it would be the kind of thing that a place hundreds of babies are regularly born *should* be able to handle because it's going to happen during the normal course of business. And apparently that was the case were before the place closed, because this lady had not planned on traveling 2 hours before then, so it's not a totally off the wall idea.
All I slightly disagreed with you about was whether the amount of twins or otherwise high risk pregnancies they'd anticipate serving in an area of that size should be enough for a "decent" place to be equipped to handle those incidents. I was explaining why I'd consider preparing for twins (if you think you're going to have hundreds of births a year) to be reasonable, since it's not rare IMO. I didn't say YOU called it rare, I was just explaining my reasoning.
I am in education, but I also have a PhD. I ran pre-med programs at two different universities and a big chunk of my dissertation (and other) research involved the state of modern healthcare. So I do know something about the topic. I'm not proposing to be an expert but I'm not pulling an opinion out on my arse either. Anyway I'm just talking about what I think should be available given how many births occur in that area, no biggie. People can differ and all that.
I'm not sure how we got to the hostile phase? Was I being disrespectful to you or something? I thought we were just talking, exchanging ideas here. Can we bring this down a notch or two? LOL
I didn't say most hospitals are for profit? I said this one closed because it was. But even non profit hospitals have to consider money because of how they are funded. That's fine! It is what it is.
I'm not sure why you are giving the rate of twin births here because I never argued with you about that? I used the numbers you posted in my own response.
And I never said twins were "frequent", just common enough IMO that it would be the kind of thing that a place hundreds of babies are regularly born *should* be able to handle because it's going to happen during the normal course of business. And apparently that was the case were before the place closed, because this lady had not planned on traveling 2 hours before then, so it's not a totally off the wall idea.
All I slightly disagreed with you about was whether the amount of twins or otherwise high risk pregnancies they'd anticipate serving in an area of that size should be enough for a "decent" place to be equipped to handle those incidents. I was explaining why I'd consider preparing for twins (if you think you're going to have hundreds of births a year) to be reasonable, since it's not rare IMO. I didn't say YOU called it rare, I was just explaining my reasoning.
I am in education, but I also have a PhD. I ran pre-med programs at two different universities and a big chunk of my dissertation (and other) research involved the state of modern healthcare. So I do know something about the topic. I'm not proposing to be an expert but I'm not pulling an opinion out on my arse either. Anyway I'm just talking about what I think should be available given how many births occur in that area, no biggie. People can differ and all that.
Can we be friends again now? LOL
I wasn't trying to be hostile, but I was irritated. I worked in health care for 45 years, mostly in maternal/child health/public health. I know a little bit about it, too. If I was hostile towards you, I apologize. Not all the comments were meant strictly for you, but for all the readers.
The implication in this thread seems to be that all hospitals are for profit. That is not the case, as I posted previously. UHC/single payer will not solve all these problems. If BugsyPal's description of France is correct, France doesn't have rural hospitals. France does have some of the best health outcomes.
As I said earlier, rural hospitals have been closing for 50 years now. I saw it when I lived in semi-rural Illinois back in the 70s. (Almost 50 years ago now.) I've seen it here in Colorado in the past few years. Transportation is better than it was in 1950, or 1900 when some of these hospitals were built. Lifestyles are different.
Whether twins are frequent or common or some other word, it doesn't matter. They make a pregnancy and birth high risk, and that's not something that should be carried out in a small unit with at best a Level II nursery, especially in a rural area with the closest facilities for high-risk babies another 100 miles or so away. It sounds like the mom in the NYT article was about 32 weeks, and the babies were tiny. They needed (need?) a lot of care. As far as the numbers I used, I was just trying to give a real-life example.
St. Francis provides neonatal air transport. Just thought I'd mention that. My youngest was born in a Level I hospital. The woman who had just vacated the birthing room was flown with her newborn just fifteen minutes by ambulance to a Level II hospital up the road. I've always wondered about the outcome. I feel fortunate to have lived relatively near Level III trauma centers for my entire life. It's a real blessing to have great healthcare nearby, and I don't take it for granted.
I wasn't trying to be hostile, but I was irritated. I worked in health care for 45 years, mostly in maternal/child health/public health. I know a little bit about it, too. If I was hostile towards you, I apologize. Not all the comments were meant strictly for you, but for all the readers.
The implication in this thread seems to be that all hospitals are for profit. That is not the case, as I posted previously. UHC/single payer will not solve all these problems. If BugsyPal's description of France is correct, France doesn't have rural hospitals. France does have some of the best health outcomes.
As I said earlier, rural hospitals have been closing for 50 years now. I saw it when I lived in semi-rural Illinois back in the 70s. (Almost 50 years ago now.) I've seen it here in Colorado in the past few years. Transportation is better than it was in 1950, or 1900 when some of these hospitals were built. Lifestyles are different.
Whether twins are frequent or common or some other word, it doesn't matter. They make a pregnancy and birth high risk, and that's not something that should be carried out in a small unit with at best a Level II nursery, especially in a rural area with the closest facilities for high-risk babies another 100 miles or so away. It sounds like the mom in the NYT article was about 32 weeks, and the babies were tiny. They needed (need?) a lot of care. As far as the numbers I used, I was just trying to give a real-life example.
Yes, we can be friends again!
Yay! **hugs**
If I ever gave you the impression I was coming at you I truly apologize. I defer to your first hand knowledge of the topic!
Everything you said above make a lot of sense.
ETA: I just processed what you said about the conversation seeming too imply all hospitals are for profit. Maybe I contributed to that perception? I was talking about the whole health care industry being built around a profit model, not that all hospitals are for profit, if that makes sense. A lot of what happens in healthcare gets decided based around what/how much much can be billed, not what is actually needed to serve the patients. That’s what I meant by profit model. Does that make more sense?
So you are against covering viagra on public health insurance programs then correct?
Yes. Sexual activity is not a necessity the same way antibiotics or open heart surgery are. That is a real abuse.
Quote:
Originally Posted by Katarina Witt
Which still has nothing to do with this mother's age, marital status, whether she should get sterilized, re-evaluate her life or whatever. There's no need for that agenda on this thread.
That's exactly why I OP'd the thread.
Quote:
Originally Posted by lkb0714
Ah, and now we get to the crux of the issue. Because of your assumptions of her life (not included in the article btw) you feel you get to judge her as "unworthy". How christian of you.
I'm not judging her as "unworthy." I doubt she specifically wants the children so much as a roll in the hay. I don't want to pay for it.
This article describes the distress in the southeastern corner of Missouri, but could really be Anytown, USA. Specifically the article concerns people whose nearest obstetric facility is 50-100 miles away, and they're about to give birth. Two heart-rending snippets from the article (article about two print pages so quoting not a TOS violation):
The million-dollar question is, how are people going to afford a proper raising for a baby if they can barely afford gas for a 50-mile drive to a hospital? Even that drive, a 100-mile round trip, involves, say, five gallons, or about $15.00.
What people really need to think about individually is how they can maintain a decent lifestyle, for themselves and those thrust into their lives. And society needs to find a way to employ people productively. Reducing single parenthood would go a long way on both.
I opened another thread, Liberation Movements Gone Mad - Bad Behavior, Teen Pregnancy, Truancy and Hopelessness in the Heartland - Any Solutions, about another aspect of rural distress. Entertainment, such as is available and affordable, promotes questionable values and behavior. And the main non-violent recreational activity available and attractive to teens and young adults is sex. The protagonist in the article who is the mother of the twins in question is 21. She already was the mother of a two year old baby.
This is an issue about responsible decision-making as well as about health care.
Obamacare has forced many rural hospitals to close since 2010.
... at the root of the problem is the crushing weight of regulation through the Affordable Care Act. The sum total of mandated automation, reporting requirements, shrinking reimbursements and increasing penalties for noncompliance with other mandates has left rural hospitals out in the cold.
Perhaps if she didn't start having kids without a committed partner, education or income she wouldn't be complaining about no gas money to travel to the hospital.
Again, you're assuming a lot that is irrelevant anyway. Her relationship status, education nor income would have changed the fact that she's miles away from the care she and her twins needed.
Quote:
Originally Posted by 2mares
I've known several women who had twins. They delivered normally in a regular hospital with out a NICU.
More anecdotes about perfect people? Oy ...
Quote:
Originally Posted by 2mares
If she had not gone into premature labor
But she did. What should she do, make it stop?
Quote:
Originally Posted by ChrisC
That's what midwives are for.
That argument already failed miserably about 100 posts ago.
well since some of the posters suggested some of us are suggesting only rich people can breed, (it also has nothing to do with hospital closing) I just thought I need to contribute my .02
that is all. (shrug)
Or maybe people who actually EARN their way in life don't like smug, judgemental, condescending comments from silver spooners born on third base who act like they hit the triple themselves. (Shrug)
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