OBGYN deserts grow in South Georgia

As more O.B. facilities shut their doors, the distance between places offering this care grows larger. That can be a barrier for women needing prenatal care.
Published: Apr. 28, 2023 at 7:10 PM EDT
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ALBANY, Ga. (WALB) - Happening right now in South Georgia, expectant moms are spending 30 minutes to an hour driving to an OBGYN’s office due to labor and delivery closures in hospitals and medical malpractice suits against providers.

“My labor and delivery is closing down and it’s like last minute and I need to know where I’m gonna have my baby,” said expectant mom, Angel Glass.

Glass is just one of many moms left without O.B. care after her Donalsonville hospital announced they were closing their labor and delivery unit.

“Donalsonville Labor and Delivery is closing. So that’s going to have another influx of patients that had a critical care access center that they no longer have within Donalsonville, so now, those patients are going to look for other providers,” board-certified OBGYN Sheena Favors said.

An administrator for Donalsonville Hospital said the decision to close their unit was strictly financial. These types of closures are nothing new in South Georgia. Most of the counties surrounding larger medical centers have closed their O.B. and delivery services too. This creates a strain on the major facilities that are still open.

“As a mom, you know, you want the best. So, I’m thinking well I want to go to Dothan or Albany. You know, you hear wonderful things and to be constantly turned away, the more the panic sets in,” Glass said.

Glass plans to transfer to Bainbridge for her prenatal care and delivery. In fact, most of the patients from Donalsonville will do the same. Memorial Hospital & Manor in Bainbridge says they are planning to hire Donalsonville’s O.B. and some staff members to prepare for the influx of patients.

“The fact is, rural healthcare is a challenge to keep the services going. We’re fortunate to have three OBGYNs and a nurse practitioner in our office. The goal would with another influx of these patients would probably be to hire Dr. Lenz, so that would be four physicians,” said Jim Lambert, CEO of MHM.

This map depicts Labor and Delivery closures in red, and current facilities in black.
This map depicts Labor and Delivery closures in red, and current facilities in black.(GA OBGYN Society)

As more O.B. facilities shut their doors, the distance between places offering this care grows larger. That can be a barrier for women needing prenatal care, especially those with income, transportation, or insurance limitations.

“Access to care is a crisis across the country. Certainly, Georgia has its fair share of lack of OBGYNS. I believe there’s, you know, eight or nine counties in Georgia with no licensed physicians, and at last count, 75 counties with no obstetrician/gynecologist, and that’s a real problem. So, these patients don’t have access to care. And as you can imagine, not having prenatal care can lead to many different issues. It certainly makes any obstetric emergency more likely,” said D.O. Joanne Kakaty-Monzo, PCOM’s Department of Obstetrics and Gynecology Academic Chair.

When these emergencies occur, the O.B. provider can face legal action from their patients.

“O.B. is one of the highest litigious fields in the specialty of medicine, we typically always rank in the top four for medical malpractice costs, so that your insurances a lot higher than most of your other specialties. And it is well known that OBs get sued on average more often than a lot of the other medical specialties,” said Randall Sisam, D.O. and Director of Primary Skills at PCOM.

But there are things that medical centers can do when it comes to helping O.B.s avoid lawsuits and to recruiting more O.B.s.

One is participating in O.B. emergency training like PCOM offers.

“It allows us to use both high-fidelity simulators and also test trainers to first be able to recognize that this is potentially a problem in O.B. emergency, and then also to practice some of the maneuvers that would be needed to lead to resolution,” said Brian Mann, Chief of Simulation Operations at PCOM.

I submitted open records requests to all of the major medical centers in our region. None currently offer any type of litigation protections for O.B.s that have the rights to deliver at their facilities. However, some, like Phoebe and South Georgia Medical Center, have O.B.s on staff to specifically help with emergencies, freeing up outside providers from that legal risk. This also helps with work-life balance.

“I think instituting these laborists and or hospitalist programs will help. Sometimes hospitals will bring in locum tenens, which are temporary positions that cover that practice if physicians need to have a vacation. My first practice in obstetrics was in Southwest Georgia, where the state help reduce the burden of my student loans for every year that I stayed in that practice in that area. I think that’s a way that they can offer incentives to O.B. to come out and get their loans paid off,” Randall Sisam, D.O. and director of primary skills at PCOM, said.

When it comes to recruiting more O.B.s to this area, the solutions we’ve already explored might not be enough. That’s where other incentives and programs come in.

“The importance of having actual programs targeted to rural medicine. So we see that a lot with family medicine and other specialties. I don’t really see that a lot, specifically for obstetrics and gynecology,” Justice Dove, a second-year D.O. student at PCOM, said.

There is still hope that these changes will bring out the next generation of providers and start growth in what’s considered an OBGYN desert in South Georgia.

Bainbridge Memorial Hospital and Manor hope to help women in those rural areas get prenatal care with office visits in Blakely and Donalsonville. The transition will begin in July 2023.