calls a \u201cmaternity desert\u201d<\/a> larger than Connecticut.<\/p>\n\u201cI think everyone understands that we did everything we could to keep (labor and delivery) from going away,\u201d Grolemund reflected in a recent interview, describing an expansive but ultimately futile nationwide effort to recruit the doctors needed to keep childbirth services in place. \u201cWarren County is a wonderful community. Everyone knows each other. We care for each other. That is why what has happened is such a difficult thing for all of us.\u201d<\/p>\n
Warren is hardly alone. Twenty-three of the state\u2019s 67 counties \u2013 all rural \u2013 currently have no hospital offering labor and delivery services. That number is likely to rise as more hospitals terminate high-cost, low-revenue departments or close their doors altogether.<\/p>\n
Thirty-two commonwealth hospitals have, in fact, shuttered over the past 20 years. (The latest, in mid-February, was Bradford Regional Medical Center, also in Northern Pennsylvania.) Each closure, whether of a department or an entire hospital, puts additional pressure on the closest nearby facilities that inevitably absorb the patient load.<\/p>\n
The situation presents a particularly thorny challenge for both healthcare leaders and policymakers, coming as it does against the backdrop of changing demographics: By 2030, 1 in 3 Pennsylvanians will be over 60, and there is projected to be a persistent shortage of physicians, particularly OB-GYNs.\u00a0<\/p>\n
Then there are the brutal economics of rural healthcare \u2013 a shrinking and increasingly uninsured clientele, low Medicaid reimbursements and soaring labor and insurance costs.<\/p>\n
\u201cThis (OB-GYN) shortage is very impactful to rural Pennsylvania,\u201d said state Rep. Kathy Rapp, a Republican who co-chairs the House Health Committee, and whose district includes Warren.\u00a0<\/p>\n
She and her Democratic Health Committee co-chair, State Rep. Dan Frankel of Pittsburgh, are leading Pennsylvania\u2019s efforts to address the crisis through a multipronged approach that includes more funding for OB-GYN recruitment and workforce development, greater recruitment of foreign physicians and policy reforms that address the state\u2019s sky-high medical malpractice rates.<\/p>\n
\u201cWe have smaller hospitals,\u201d explains Rapp of rural regions\u2019 challenges. \u201cThe pay might not be as much as an OB-GYN would receive in a larger hospital. And then the OB-GYN practice area has always been very high in liability cases.\u201d<\/p>\n
Balancing safety and proximity<\/p>\n
The bipartisan concern about OB-GYN shortages underscores a key point: Virtually no one argues for closing labor and delivery departments. Hospitals that do so insist it is a decision made only when staff shortages, not finances, make childbirth services untenable.<\/p>\n
That was the case at St. Luke\u2019s Grand View Hospital in Sellersville, Upper Bucks County, which abruptly paused maternity services in December 2025 after multiple unanticipated physician resignations left the OB-GYN department understaffed, according to hospital officials.<\/p>\n
And it was the situation at UPMC Cole in Coudersport, which cited provider shortages when closing down its labor and delivery services last spring, according to Patti Jackson-Gehris, North Central Pennsylvania market president for the UPMC health system.<\/p>\n
\u201cAt times, UPMC Cole\u2019s labor and delivery unit had a vacancy rate approaching 50%,\u201d she noted. \u201cWithout adequate staffing, maintaining the around\u2011the\u2011clock coverage required for a safe, fully operational maternity unit became unsustainable.\u201d<\/p>\n
The health system consolidated area maternity services at UPMC Wellsboro, an affiliate hospital that is 40 miles and nearly an hour\u2019s drive away. Jackson-Gehris said that families can still access prenatal, postnatal and gynecologic care in Coudersport.<\/p>\n
In 2024, Penn Highlands Elk, another Northwest Pennsylvania hospital, closed its labor and delivery unit in a similar scenario: Elk County had only one OB-GYN, and the hospital estimated it would need three more to support childbirths in a sustainable manner.<\/p>\n
With births down to nearly 100 per year, the economics of finances, personnel and demand simply didn\u2019t work out, according to Penn Highlands officials. Local labor and delivery needs were directed to Penn Highland\u2019s Dubois hospital, a 45-minute trip away.<\/p>\n
UPMC has also consolidated maternity care across several of its facilities, in addition to the closure of the Cole facility. \u201cWe\u2019re struggling with a declining population; much of our population is aging, and the younger generation is not staying,\u201d said Jackson-Gehris, adding that childbirth demand has fallen accordingly. \u201cThese factors contribute to limited availability in the workforce, which then makes it difficult to recruit and retain staff, especially for highly skilled and specialized roles.\u201d\u00a0<\/p>\n
In 2019, UPMC\u2019s Pittsburgh-area Mercy facility moved childbirth services to UPMC Magee\u2011Womens Hospital, its regional hub for advanced obstetric and neonatal care. The year prior, UPMC Bedford had shifted its delivery services to nearby UPMC Altoona, an affiliate of UPMC Magee-Womens.<\/p>\n
\u201cThese decisions are always made with patient safety, quality of care, and long\u2011term sustainability in mind,\u201d said Annmarie Lyons, UPMC\u2019s vice president, Women\u2019s Health Services.<\/p>\n
UPMC has also worked closely with Warren General to help expectant mothers deliver at UPMC Chautauqua in Jamestown, New York, about a half-hour north of Warren; it also added outpatient midwifery services in the Warren and Bradford communities. Rapp said the health system had set up a dedicated hotline with information about UPMC\u2019s labor and delivery services and transferring care.\u00a0<\/p>\n
On its website, Warren General advises pregnant patients that the hospital has coordinated care with OB\/GYN Associates of Erie, with inpatient deliveries to take place at Magee-Womens Hospital of UPMC Hamot and Saint Vincent Hospital, both roughly an hour and a half west of Warren in Erie.<\/p>\n
Technology can help fill local gaps in care, said Lyons, the Women\u2019s Health Services chief at UPMC. She noted that Magee-Womens Hospital offers maternity counseling via its telemedicine service, including virtual doula visits and childbirth education.<\/p>\n
Recruitment is futile<\/p>\n
Amid a nationwide OB-GYN shortage that stands out even amid the broader physician shortage, Grolemund mounted a massive effort to keep Warren General\u2019s labor and delivery department open.<\/p>\n
He spearheaded a nationwide personnel search, personally appealing to nearly 30 OB-GYN residency programs and working with 10 physician recruitment agencies to identify candidates willing to deliver babies in North Pennsylvania. He reached out to every available candidate on Practice Link, the main physician job board.<\/p>\n
The hospital was willing to pay what is known as a \u201crural premium\u201d to compensate obstetricians for the increased responsibility of being on call for childbirth around the clock at least half the month \u2013 a hard sell compared to busy urban practices, where OB-GYNs may only be on call a few days per month. Moreover, Warren General was prepared to spend the $150,000 it could cost for each OB-GYN\u2019s malpractice liability insurance \u2013 among the highest rates for any specialty.<\/p>\n
Yet Grolemund still came up empty-handed. \u201cThere just aren\u2019t enough OB-GYN doctors to meet the current demand,\u201d he said. \u201cIt is so tough to find available OB-GYNs, especially to come to rural America.\u201d<\/p>\n
The statistics illustrate Grolemund\u2019s seemingly impossible quest. Half of all OB-GYNs in America are 55 or older; over the next several years, an estimated 30% are expected to leave practice, further expanding the nation\u2019s maternal deserts.<\/p>\n
Age is one reason they leave; stress is another. OB-GYNs are the second-most-sued doctors nationally, second only to general surgeons, and have among the highest burnout rates across medical specialties. Aspiring physicians understandably gravitate toward specialties with gentler schedules, more reliable hours and shorter training.<\/p>\n
\u201cFour years of undergrad, four years of medical school, four years of a residency, and then two to three years of a fellowship \u2026 Not a lot of kids who come out of high school can commit to 12 to 15 more years of education,\u201d noted Grolemund.<\/p>\n
Frankel, Rapp\u2019s Democratic Health Committee co-chair, pointed to other recent factors that have compounded the OB-GYN workforce shortage.<\/p>\n
One was the COVID-19 pandemic, which worsened an existing crisis in maternity care by stretching physicians thinner and accelerating OB-GYN burnout. \u201cA lot of people left the workforce; it was just too much for them,\u201d Frankel said.<\/p>\n
More recently, the federal immigration crackdown has exacerbated the workforce shortage by virtually halting new arrivals. Foreign-born workers constitute nearly a third of Pennsylvania\u2019s long-term care labor force; indeed, the state depends on immigrants to staff every level of healthcare, from physicians to home health aides.<\/p>\n
The liabilities of liabilities<\/p>\n
Nicole Stallings, the CEO of the Hospital and Healthsystem Association of Pennsylvania, cited a recent report<\/a> from the American Medical Association showing that Pennsylvania had the nation\u2019s second-highest increase in medical liability insurance premiums from 2023 to 2024, behind only Hawaii.\u00a0<\/p>\n\u201cPennsylvania is a net exporter of physicians,\u201d she added, \u201cand we believe one of the primary reasons for that is our liability climate.\u201d<\/p>\n
The result is that women in Pennsylvania\u2019s rural regions commonly face an hour-long trip to a specialized childbirth unit. According to experts, health outcomes will inevitably suffer when pregnant women are forced to travel for specialized care in emergency situations that can arise around late pregnancy and childbirth.<\/p>\n
\u201cIf there is delayed care, we all know that there are consequences to the baby,\u201d said Pennsylvania Association of Staff Nurses and Allied Professionals President Maureen May, who, as a neonatal intensive care unit nurse at Temple Health in Philadelphia, has witnessed such scenarios.<\/p>\n
May said that all paramedics and emergency medical personnel are trained in delivery and neonatal resuscitation \u2013 but added that such training is no substitute for a department that specializes in childbirth. \u201cIf an (umbilical) cord is wrapped around the baby\u2019s neck, and you can\u2019t monitor that baby, obviously, they can\u2019t have a stat C-section in the middle of driving them,\u201d she said.<\/p>\n
\u201cThe health system should be working on how to manage rural care,\u201d she added. \u201cI know people who have said, \u2018I\u2019ve moved to an urban area to be close to a hospital that has the ability to care for me.\u2019 Some people actually make that choice. Others don\u2019t have that choice. So for them, how do we make outcomes better?\u201d<\/p>\n
Tomorrow: City & State looks at the short- and long-term strategies lawmakers and health officials are proposing to try to reverse Pennsylvania\u2019s maternity crisis.<\/p>\n","protected":false},"excerpt":{"rendered":"\u200b\u200bFor Warren General Hospital CEO Dan Grolemund, the closure of the facility\u2019s maternity unit was particularly resonant. He…\n","protected":false},"author":2,"featured_media":129840,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[338,28,30,29,5647],"class_list":["post-129839","post","type-post","status-publish","format-standard","has-post-thumbnail","category-pennsylvania","tag-healthcare","tag-pennsylvania","tag-pennsylvania-headlines","tag-pennsylvania-news","tag-policy"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/posts\/129839","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/comments?post=129839"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/posts\/129839\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/media\/129840"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/media?parent=129839"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/categories?post=129839"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-pa\/wp-json\/wp\/v2\/tags?post=129839"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}