Newton Clinic and MercyOne Newton Medical Center are going to pause all labor and delivery services indefinitely, citing a decade of “significant recruitment and physician workforce challenges” that have forced the care centers to now investigate other options to provide these types of services to rural areas.
In a joint statement released on Friday, Aug. 30, by Newton Clinic Administrator Mark Thayer and MercyOne Newton Chief Operating Officer Chad Kelley, the clinic announced it will cease its search for physicians dedicated to obstetrics. The hospital, in turn, must stop all newborn deliveries after Oct. 15.
All mothers expected to deliver after Oct. 15 are encouraged to continue their prenatal care appointments with their obstetrical physician in Newton Clinic to discuss their care and options for transfer and delivery. Mothers scheduled to deliver prior to that date will continue to receive care and can deliver in Newton.
“Aș difficult aș this decision is, patient safety is of utmost importance to both organizations,” the statement said. “Both the Newton Clinic and MercyOne Newton Medical Center will continue to commit to the high standards of prescribed and emergency care followed by every care center in Iowa.”
Furthermore, hospital policies and procedures — along with interfaculty arrangements — are in place to safely care for and triage all patients.
Nurses employed in the labor and delivery department at MercyOne Newton Medical Center will be offered continued employment in other positions and departments. Thayer told Newton News in a follow-up interview there is nothing he worked harder on in the past five years than recruiting obstetrics providers.
“We’ve had success bringing in providers and then all of a sudden the door just shut on us in the past 12 months,” Thayer said in a recent phone interview. “We’re losing Dr. (Sarah) Florence, and we can’t do it with one doctor. Dr. (Tara) Gravenstine has announced no plans to leave.”
Newton Clinic is actively looking for options for Gravenstine to deliver her patient’s babies at other hospitals or at least provide prenatal care. Thayer said the clinic historically has exclusively provided obstetrics services at the adjoining hospital; it was the only hospital that providers were able to deliver at.
“That has worked for probably the last 100 years,” Thayer said. “At one point almost every one of our doctors did OB. I’ve been at the Newton Clinic now for 28 years and I think at one time I had six providers that were all doing OB. Part of the problem is as providers get older they sometimes pull back on services.”
Other factors are at play, too. Thayer said some doctors are lacking cesarian section, or C-section, experience when they compete their residency. To establish that competency, he said it takes a minimum of 25 to 50 completed C-sections. There was a time when Newton could train those services locally.
“But they don’t allow that anymore,” Thayer said. “We’re also finding a lot of new doctors just want to have an outpatient practice and don’t want take on OB or really even step foot in a hospital. Really, they just want to have a clinic practice. Which is understandable. We’re kind of faced with two storms simultaneously.”
Health experts have been warning about the shortage of obstetricians and gynecologists for years. Thayer said it has been challenging trying to find that skillset for Newton Clinic. It is also cost-prohibitive for the clinic to have two OB-GYNs on staff because it lacks the volume to support it.
Newton’s higher percentage of Medicaid reimbursem*nts — which typically do not reimburse as well as commercial insurance — also limits revenues. While costs certainly play a factor in maintaining plentiful and quality maternal care, Thayer said it is not the primary factor.
“The main factor is doctors are coming out of residency without having C-section competency, and only a small percentage of them want to even do OB,” he said.
Although Thayer was skeptical any political issues had any affect on the clinic, many warned the state’s more restrictive abortion law passed one year ago would have a strong negative impact on rural health care, which was already steadily losing many of its labor and delivery units.
According to the American College of Obstetrics and Gynecology, Iowa ranks 52 out of 52 states and territories for OB-GYN physicians per capita.
Thayer noted the clinic’s location between at least two other maternal care provider areas 30 minutes awau gives patients more options and thus limits their volume of deliveries. Newton Clinic typically delivers 100 babies per year. A couple of years ago staff were delivering upwards of 190 babies per year.
“That number has trended down partly because we’re getting really choosey in terms of risk factors,” Thayer said. “Patients that have elevated BMIs are unable to deliver in Newton, and if they have other prenatal risk factors they are typically transferred to higher care facilities such as Des Moines.”
Pam Pratt, a Newton mother of two boys, was sad to hear the labor and delivery services were put on hold for the foreseeable future.
“Both of our boys were delivered here in Newton, and we had great experiences with both prenatal and delivery care from the doctors and nurses at the clinic and MercyOne,” she said. “It is heartbreaking for the city to lose access to this kind of medical care. Thank you to the doctors and nurses who served our community well.”
Nicole Terry, a Newton mother whose 1-year-old son was born in town, was also saddened to hear the recent news. Her son was a geriatric, high-risk pregnancy, and Terry had appointments twice a week, two hours in length, during the last month before delivery.
“I was, and am, lucky enough to work within walking distance from Newton Medical Center and walked to many of my appointments,” she said. “I cannot imagine having to drive 30 minutes to and from medical appointments multiple times a week, while also recognizing that I am that much further from emergency labor and delivery services.”
Jasper County is now is an obstetrics desert, and that will not only affect future decisions for her family but many other young families in similar situations.
Terry said if she was thinking of expanding her family now, not only would access to services be a concern but also transportation costs, emergency situations, greater loss of sick leave before maternity leave and future family appointments after delivery for herself and her child or children.
“I loved my doctors, nurses, and entire experience at Newton Medical Center labor and delivery,” Terry said. “I am happy I was able to deliver so close to home with such excellent staff. I feel for all those affected by this news and worry what the long-term effects of this closure will mean for the future of Newton and its growing families.”
