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Another hospital may drop obstetrics

Chestnut Hill Hospital would become the 15th area facility to do so in the last decade. Some are calling the trend a crisis.

Is another Philadelphia-area hospital getting out of the baby business?

Chestnut Hill Hospital is reviewing its obstetrics program, raising concerns among hospital staff and others in the region that it will copy Jeanes Hospital's recent decision to close its maternity ward.

If that happens, Chestnut Hill would be the 15th area hospital in the last decade to stop delivering babies, a trend some are calling a crisis that could soon affect access to care and quality of treatment for pregnant women and babies here.

"The current market dynamics for obstetric services in Greater Philadelphia have led a number of facilities, including Chestnut Hill Hospital, to closely evaluate their programs," M. Brooks Turkel, chief executive officer of the Chestnut Hill Health System, said in a statement.

"Two other hospitals in our area have announced OB unit closures in the last year," he said. "While we continue to review our position, we have not made a final decision at this time."

The review alone, however, has many of the nurses, doctors and midwives at the hospital scared, prompting them to campaign to avoid the fate of other maternity wards in the city.

"There is a crisis, and if the fiscal specifics of running an OB department cause closures, then the system needs to be fixed," said Sandra Donover, director of midwifery at Chestnut Hill.

"This is a crisis. The other places in the area are busting at the seams," she said. "So, if we were to close, we would adding about 1,200 deliveries to an already strained and broken system."

Just last month, the Temple University Health System announced it would close the Jeanes obstetrics program on May 30 as part of a broader financial-restructuring effort.

In June 2006, Frankford Hospitals-Torresdale Campus closed it maternity ward.

The trend began 10 years ago, when MCP Hospital in East Falls closed its OB unit as its parent, the Allegheny health system, moved deliveries at its eight local facilities to City Avenue Hospital.

In 1999, City Avenue was closed by Tenet Healthcare Corp., which had acquired it with the hospitals in the Allegheny bankruptcy.

Kenneth J. Braithwaite, head of the Delaware Valley Healthcare Council of the Hospital and HealthSystem Association of Pennsylvania, which represents local hospitals, said the string of closings leaves maternity care in a bind.

"In Philadelphia there are nine facilities that are still providing obstetrics services," he said. "Even though there is a projection that the number of births is declining, a 28 percent decrease in obstetrics capacity leaves us in a real crisis situation."

Delivering babies is a tough business. Hospitals and doctors get relatively low payments from insurers and government payers such as Medicaid, and incur high expenses, especially for medical-malpractice premiums.

In the last decade, the number of births has held relatively steady at about 65,000 per year in the eight-county Philadelphia region.