Growth of ‘maternity care deserts’ could impact care for women across Middle Tennessee

NASHVILLE, Tenn. (WSMV) - There’s growing concern over the care for pregnant women and their babies as more Tennessee counties are named “maternity care deserts.”

That’s when there’s no hospital or birthing center for women to deliver babies in an entire county.

Henry County will soon join that list. Henry County Medical Center announced it will be ending obstetric services on Sept. 1.

“We’re devastated for the moms. I mean, there’s gonna be so many babies and mamas that don’t receive care because they don’t have a way to get an hour away,” Sara Horton, an area mom, said.

Horton delivered her 2-year-old son Graham by emergency c-section at Henry County Medical Center. Her umbilical cord bust during labor.

“Until he was born, my life and his life was in danger,” Horton said.

According to a 2022 March of Dimes report, more than a third of Tennessee counties are maternity care deserts. The report said that fact increase a woman’s risk of death due to pregnancy.

“There are patients who are going to fall through the cracks,” Dr. Pamela Evans, an OB-GYN who delivers babies at HCMC, said. “Inside the state of Tennessee, we’re about an hour drive to an hour, 15 minute drive from our closest facilities that also offer obstetrical services.”

She said not only are they concerned that women may not be able to get regular prenatal care, but she said HCMC’s closure will put pressure on hospitals in Jackson, Clarksville or even Nashville.

“They will be trying to be the safety net for patients that have been without a close access to care,” Evans said. “It makes their jobs even harder.”

John Tucker, CEO of Henry County Medical Center, said the decision to close obstetric services comes down to insurance money. While he did not sit down for an interview for this story, during a community meeting in June he blamed a decline in patients and low payments from Medicare providers, particularly BlueCare, a branch of BlueCross BlueShield of Tennessee.

“We need to make some difficult decisions, or this organization doesn’t survive through the fall,” Tucker said during that meeting.

WSMV4 reached out to BlueCross BlueShield about the claims. In an email, they said they weren’t aware of the hospital’s financial issues until after the public announcement in May 2023. They also said they last signed a contract with the facility in 2019, but it did not include an increase in reimbursement rates for obstetric care. BlueCross BlueShield said, “the facility did not request one.”

It’s common for hospitals to renegotiate how much insurers will reimburse them for services every few years. WSMV4 asked HCMC if it made a mistake by not requesting a reimbursement rate increase for maternity care. The hospital did not respond.

BlueCross BlueShield said the hospital did request a rate increase for maternity care in June 2023 after announcing the end of obstetric services. They said that request is moving through review. In the meantime, those working at the hospital said steps are being taken to end services by the announced Sept. 1 date.

People like Evans and Horton aren’t giving up. They hope speaking out will spur a last-minute solution.

“I worry without it you’re gonna lose mamas and babies,” Horton said. “How many moms and babies is it gonna take for them to understand? We need this.”

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