Baby deliveries to end at PMC

Robert Monteith

September 11 , 2008.

The Petersburg Medical Center Board last Thursday voted to stop providing obstetric services at the city’s medical center. The board voted 4-0 in favor of accepting the medical staff’s recommendation to close the service. A lengthy discussion and hesitancy on part of the board weren’t enough to keep deliveries from occurring in Petersburg.

Dr. John Bringhurst, hospital administrator, led the discussion by stating that everyone at the hospital wanted to continue delivering babies, but several factors were making them consider otherwise.

“The physicians, administration, our staff...everybody would prefer to see the deliveries continue here at Petersburg Medical Center. The question is – should they? Is it really appropriate to do that? That’s kind of what we’ve been discussing,” he said. He maintained that the hospital would continue offering prenatal and postnatal care for Petersburg residents.

One key factor is a change in perception as to the medical standards of deliveries. The ability to offer a cesarean section in case it is necessary is now considered a routine part of OB care.

“Surgical delivery backup is pretty much the standard of care for doing deliveries in the United States. That’s a service that we have not been able to offer here, nor does that look like something that we can offer here,” explained Bringhurst.

Several factors stand in the way of offering surgical backup, including the need for extensive training in the procedure for both nurses and doctors as well as training in anesthetic delivery.

The only doctor on staff who feels himself qualified to deliver an anesthetic is Dr. John Bergren who said he had hoped an incoming doctor would also share his interest in OB care.

“My biggest hope had been that when Dr. Tuccillo left that we would be able to hire a doctor that had a little bit more motivation to pursue this sort of program. That was sort of my last hope. We have really struggled. We’ve struggled to find doctors who even don’t do OB, but we’ve had to tell the ones that are interested that we’re still interested in doing OB. Only recently did we sort of push this because we’re so pressed to find a new doctor,” he said.

Bergren called the search for another doctor a conundrum because the candidates who were interested in it found Petersburg unattractive due to decreasing birth rates.

“It’s a Catch-22 because as our volumes have gone down, the ability to attract people with an interest in doing OB is much more challenging,” he said.

Bringhurst stated that canceling the service had nothing to do with money, although money spent traveling to Juneau or Ketchikan and renting a hotel while waiting for the delivery was a concern for board member Kristine Kissinger. “The money part of it is huge. You’ve got people that are monied and it’s not a problem. You’ve got people on Medicaid and it’s not a problem. It’s those people in between and it’s a huge expense,” she said.

Local resident Gina Esposito said that waiting in another city might also force a birthing mother to make rash decisions. “You might be forced to make decisions about your birth that you wouldn’t necessarily make because you’re under stress or pressure to have it done quickly. You might go through an induction when really you’re forcing your body to start something too early. You know, if you have a doctor who recommends inducing, you might be pressured into doing something like that because you don’t have the resource to stay where you’re at.”

Another board member, Zach Hays, said he had recently spoken to a malpractice lawyer who had toured the facility. According to him, her advice was to stop services immediately. “Based on the size of the facility and the location, geographically speaking, that we really shouldn’t do it because the risk is so great. She said it just takes one bad experience gone wrong and, depending on a lot of variables, it could be enough to sink the hospital,” he said.

The matter was called to a vote after a long silence, each board members were hesitant to actually end the service deemed important by the public. Board President Tom Abbott considered tabling the issue until next month, but the vote was finally called.

Those currently under prenatal care may still birth at Petersburg Medical Center. The hospital is expected to release a cutoff date soon.