A western Wisconsin hospital is expanding its labor and delivery unit while others close

Five years ago, the Western Wisconsin Health hospital in Baldwin, Wisconsin, delivered about 100 babies, mostly to patients who lived in the community.

This year, however, the hospital expects to deliver close to 300 babies. And instead of the patients coming from its small community of about 4,000 people, some of them are traveling upwards of 80 miles to give birth at the hospital.

More and more rural hospitals across the state and the country are closing their labor and delivery units. In the United States, nearly half of rural hospitals had stopped delivering babies in 2020, and at least 89 rural obstetric units closed between 2015 and 2019, according to the American Hospital Association. Wisconsin experienced a 2% drop in hospitals that were delivering babies between 2019 and 2020, according to March of Dimes, which listed 11 of the state’s 72 counties as maternity care deserts.

In the last two years, five hospitals in northwest Wisconsin have closed their labor and delivery units, according to WWH CEO Eilidh Pederson.

“We find ourselves truly at a crisis inflection point when it comes to rural obstetrical care,” Pederson said.

Despite the current state of maternal health care, the WWH hospital has not only kept its labor and delivery unit open, but it’s also expanding the department with the help of federal funding to accommodate the influx of patients with nowhere else to go.

“While others chose to close, we chose to double down on our investment,” Pederson said.

She hopes that the model the hospital is following, as well as the partnerships it’s creating, will pave a path to make maternal health care more sustainable.

‘The right thing to do’

As hospitals face financial stressors, obstetrical units are often among the first things to be shuttered, Pederson said.

This is largely because they’re expensive departments to keep open. They require a lot of specialized staff that need to be on the clock 24/7. Medicaid reimbursement rates are also lower for OB-GYNs than other providers, meaning they get paid less for their services, a compounding problem because Medicaid covers nearly half of all births in the U.S., especially in rural areas.

“If you’re looking to save expenses and cut your losses, obstetrical care is going to be the first one to go because most hospitals lose money on it,” Pederson said.

Expanding the labor and delivery unit at WWH hospital isn’t necessarily a good business plan, Pederson said. The total cost to expand the department from two to five beds will be $7 million, and the hospital estimates it will take 31 years to recover the costs. “You present that figure to any other hospital and they’re going to say you’re out of your mind,” Pederson said.

But WWH isn’t doing it to make money.

“We do this because it’s the right thing to do, because it’s a human rights issue, and because from our perspective, you can’t be a community hospital, you can’t be a safety net hospital, which is what we are, unless you deliver babies,” Pederson said. “We knew we had to do it, but we knew we needed help.”

Some of that help is coming by way of $1 million from the latest federal spending package, funds that were secured by Democratic U.S. Sen. Tammy Baldwin. The hospital has received other community grants and a donation from Kwik Trip. In total, it’s raised $3.6 million for the expansion, which will also include a new medical surgical unit. The hospital is covering the rest of the bill.

A foundational investment

When the new Baldwin labor and delivery unit opens in early June, it will have three additional beds and be able to deliver close to 450 babies a year.

In the last three weeks the hospital has seen its births grow by close to 100, Pederson said. Many of those new patients are traveling from the Eau Claire and Chippewa Falls area, where two hospitals and 19 clinics are closing.

“So this construction could not be finished and these additional rooms cannot be coming at a more impactful time,” Pederson said.

WWH has found success by constantly finding ways to be efficient, she said. Patients choose to deliver at the hospital because the hospital hires staff that many others don’t have, like certified nurse midwives. Pederson said the hospital also tries to maintain a leaner core staff without being understaffed, and it works with residency programs to save costs.

The hospital’s partnerships have been key to staying afloat, Pederson said. It shares a physician with nearby Hudson Hospital, for example, who helps occasionally cover weekends and evenings in Baldwin. And it partners with the Minnesota Children’s Hospital, which provides telehealth assistance when a baby is in critical condition.

Pederson said that the funding from the federal government is the start of a new partnership that she hopes can create a new model for investing in rural maternal health.

“It’s our foundation for healthy life,” Pederson said. “What’s more important than how you start your life and bringing healthy life into this world? It’s maddening that these problems exist because, healthy deliveries, we aren’t humankind without that. And so it’s critical that this type of health care is prioritized. And, you know, so much talk is on women’s health, but truly, this is a human health issue, and it’s important that this gets prioritized.”