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Health Equity

Another Hospital Closure Means Another Maternity Ward Closes, Too

Shutting down AMC could create even more challenges for communities of color seeking maternal health care.

Closing Atlanta Medical Center worsens a trend that helped make Georgia one of the deadliest states in the country for pregnant people, particularly Black women. (Kenya Hunter/Capital B News)

When Aleah Walker had her baby in late January 2014, she wanted to give birth at Atlanta Medical Center. Walker, a Powder Springs resident at the time, wanted a water birth and was willing to drive over 20 miles to Atlanta Medical Center because it’s one of the few hospitals in the metro area where she could go for that procedure. She was surrounded by her husband, her two doulas, and other family members. 

“I had my baby all natural, in the water, and I was able to sit for a little bit in the water,” she joyfully recalled. “Then I got out, my husband did skin to skin, and you know they did their postpartum recovery with me.” 

Now, with Wellstar planning to shut down AMC on Nov. 1, Walker, who is also a doula, worries about what losing the labor and delivery unit means for uninsured, lower-income patients.

“It really makes me nervous … because people are still having babies,” Walker said. “So you’re losing 20 beds, where are people going to go?” 

Wellstar’s decision to close Atlanta Medical Center has left many worried for the overall health care infrastructure in the city. Once the hospital shuts down, the city loses 20 labor and delivery rooms and 38 rooms dedicated to immediate postpartum care. 

It worsens a trend that helped make Georgia one of the deadliest states in the country for pregnant people, particularly Black women. Statewide, 38 labor and delivery units have closed in the state between 1994 and 2020, according to the Georgia Obstetrical and Gynecological Society. At least six have been in the metro Atlanta area, including the labor and delivery unit at what used to be South Fulton Medical Center under Tenet Healthcare, which closed its unit in 2012. Wellstar later bought South Fulton Hospital along with Atlanta Medical Center from Tenet. 

“There’s definitely a correlation that when you have fewer birthing opportunities, and fewer labor and delivery suites, that mothers don’t do well,” said Dr. Madeline Sutton, an OB/GYN who delivers at Grady Memorial Hospital and is the founder of One Brain 4Health. “In Georgia, and as well as other states across the country, Black and African American women are usually the ones who are hardest hit.” 

Black women are more than two times more likely to die from pregnancy-related deaths than white women, according to the Georgia Department of Public Health. Much of this has to do with factors such as lack of health insurance, limited medical options in rural areas, and reliable transportation.

Other metro hospital closures include Dunwoody Medical Center and Northlake Regional Medical Center. Both closed in DeKalb County in 2006. In Fulton, West Paces Medical Center and Southwest Hospital and Medical Center closed their doors in 1999 and 2009, respectively. 

“Twenty to 30 beds, that’s a big, active unit,” said Sabia Wade, better known as the Black Doula. “If you think about that, that’s thousands of births, easily, every year. Then think about the flow of that. Now that overflow has to go to other hospitals. Where do they have space for those people?” 

Wellstar says the vast majority of doctors who deliver babies are licensed at other hospitals in the metro area and can easily transition their patients to those facilities. For the “very few” providers who aren’t credentialed at other hospitals, Wellstar says they are working with them to connect them with other hospitals. 

It’s also unclear when Wellstar will begin shutting down operations in the maternity ward as part of its “gradual” approach to close AMC by Nov. 1. 

Sutton said she expects Grady will take much of the overflow from AMC’s maternity ward, but isn’t sure it’ll be an easy transition. Grady Health System CEO John Haupert has called the move “incredibly tragic and disruptive to the patients,” noting that Grady — along with Emory University Hospital and Piedmont Atlanta Hospital — are anticipating an influx of patients.

“I think the challenge is going to be which hospitals have adequate space to accommodate [birthing people] and making sure [they] can get access in a way that is timely and that helps make sure that they have a healthy and safe delivery process,” Sutton said.

On Thursday, Gov. Brian Kemp said his administration would give Grady Memorial Hospital $130 million to add 200 beds to its operation. It is not clear how many of those beds will go toward labor and delivery. 

When asked about the closure of another maternity ward in the state, and how it might affect Black people, Kemp said his focus was on the broader implications. 

“Instead of trying to answer specific questions about any group of people that are being served at AMC, let me just tell the people of this state and the metro Atlanta region, my goal as governor was to work with these local partners to fill the gap that’s being left behind by AMC,” he told Capital B Atlanta. We believe we have a plan to do that in the near future.”

Kemp went on to say the state is working on ways to ensure they “don’t have any gaps,” in plugging the massive health care holes caused by losing AMC. “I would also remind people, there’s others out there trying to scare people about how bad the situation is,” he said before adding that additional beds at Grady are a good short-term solution. As far as long-term fixes, the governor responded that it would take five to 10 years to build a new hospital to fill the void left by AMC. 

Thomecia Busby, a full-service doula who has supported births at AMC, said many patients on Medicaid often seek care at AMC. In Georgia, Black people make up the majority of those on Medicaid, and hospitals are often reimbursed at lower rates for Medicaid patients. A recent study from the Lown Institute, a nonprofit organization that advocates for a more just health care system,  showed that AMC was the state’s No. 2-ranked hospital for inclusivity in Georgia, which means the facility scored high when it comes to providing care for lower-income patients from communities of color. Grady is ranked No. 1.

Busby also noted the diversity of staff was a plus since many of the patients seen at AMC are people of color. 

Busby said she remembers a time earlier this year when Grady was so overloaded with patients because of COVID-19, the hospital wasn’t capable of supporting birthing patients and instead diverted them to Emory or Northside. “I would assume there would be an overload,” she said. “When they have too many patients, their care for patients tends to go down.”