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Indiana 'poster child' for national health system's obstetrics closure trend says researcher

By Abigail Ruhman

Posted February 9, 2024

The president of National Nurses United, said in addition to closures, the report also highlights Ascension’s “chronic understaffing” in facilities that still provide OB care. (Devan Ridgway/WTIU)

Obstetrics care closures in Indiana contribute to the state’s high rates of maternal and infant mortality. A report shows one hospital system has been closing OB services at a higher rate than the national average — and Indiana is one of the states losing care in the process.

Ascension, a health system with 140 hospitals in 19 states, has closed 26 percent of its labor and delivery departments since 2012, according to a report from National Nurses United.

The report found that these closures were in areas with already high mortality rates and in low-income communities. Additionally, the closures occurred in predominantly Black and Latine neighborhoods, and in areas where Ascension has a “controlling market share.”

Elana Kessler, the lead author and researcher on the report, said Indiana has had three closures since 2012: Ascension St. Vincent Salem, St. Vincent Frankfort Hospital and Ascension St. Vincent Dunn.

“I just really actually see Indiana as like this, almost like poster child, this trend that Ascension is having throughout their hospitals in the country, and really just disproportionately contributing to Indiana's reproductive health crisis,” Kessler said.

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Jean Ross, a registered nurse and president of National Nurses United, said in addition to closures, the report also highlights Ascension’s “chronic understaffing” in facilities that still provide OB care.

“Nurses will and have put up with a lot over decades, including poor pay, depending on where you live,” Ross said. “But they will not continue to try to take care of their patients with not enough of us. We just can't do it, and we won’t.”

Ross said the closures and staffing issues are part of Ascension not living up to its mission to serve the communities it is in.

In a statement from Ascension, a spokesperson said the report is a “misleading representation of the clinical decisions” the system has made. It said consolidating labor and delivery services ensures the quality of the care and decreases the risks associated with neonatal transfers.

CORRECTION: A previous version of this story misidentified the number and time period of Ascension's obstetrics closures. The state has had three closures since 2012.

Abigail is our health reporter. Contact them at aruhman@wboi.org.