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No doctor around: SC pregnant moms in rural areas with no care

Maternal care "deserts" in South Carolina. (File/WCIV)

Why is maternal care is disappearing in rural communities in South Carolina?

Many mothers with high risk pregnancies live in counties without an OB/GYN resulting in pregnant moms driving for hours just to see a doctor.

Doctors say lack of access is costing mothers their lives.

Nina Hancock lives in Marlboro County and is expecting a baby boy she named Mason.

She says he is a miracle.

“He is my world, he is my everything, he’s what I've wanted for a long time and I finally get my baby," she said.

Mason is a blessing after four devastating miscarriages.

“What would my child have been like, what would my child have looked like, every death date and every birth date, you think about that. It crosses you mind. For me, it crosses my mind for four different babies,” says Hancock.

Nina's high-risk pregnancy became even more stressful when Mcleod’s Labor and Delivery unit in Cheraw closed.

"I was petrified, then I started to find a doctor on my own," she says.

The issue is her new doctor is in Florence County—over an hour away.

"Even now I think, well what if I started hemorrhaging and something happened and I needed to get assistance as soon as possible?" she says.

In Marlboro County, there is no obstetrician who delivers babies.

The March of Dimes says seven other counties in South Carolina have no OB/GYN at all.

They are: Abbeville, Allendale, Barnwell, Lee, Mccormick, Saluda and Williamsburg counties, impacting nearly 60,000 women of child-bearing age.

Several other counties only offer limited maternal care.

Dr. Scott Sullivan from MUSC says, "I do believe we have mothers die because of this."

The CDC says an average of 700 mothers die each year from pregnancy related causes in the U.S.

Doctors say maternal death rates in the U.S. have doubled over 20 years as complications increase.

Sullivan says it's caused by many factors including preterm birth, hypertension, bleeding birth defects.

"It’s a long list," he said.

Dr. Sullivan says money is the biggest factor driving rural doctors away.

“Private practices and hospitals really do struggle financially because they have a higher number patients on Medicaid and they do not pay enough," he said. "We have had conversations about increasing those rates or increasing rates for rural doctors.”

The rural doctors who are still practicing are getting an influx of out-of-town moms.

Expectant mother Ki'Tiara Locklear says she's even considering getting a hotel room near the hospital as her due date approaches.

Doctors say other mothers who have never seen a doctor at the facility just show up in labor.

Dr. Toya Danzy says, "When you are called and patients are arriving and they have not had prenatal care, you don't have records and they ready to deliver and they don't know you and you don't know anything about the patient."

Hancock says after four miscarriages and her OB/GYN closing, she’s not sure she wants to try again.

“It depends on how this goes. If I go into labor before the 38-week mark when they plan on inducing, if I were to give birth on the side of Highway 52, I would not want to go through that again," she says.

But for now she's making plans with Mason who's healthy, kicking and loved.

Nina says, "he has done everything they said he would not do, so he is a miracle baby."

McLeod released a statement about the Labor and Delivery unit closing in Cheraw.

Here’s a portion of that statement:

"First, the population in our primary service area is largely beyond child-bearing age and many residents have significant chronic health needs other than Obstetrics. McLeod Health Cheraw delivered less than one baby a day – fewer than 3 a week. Second, patient choice leads more women to seek birthing at larger facilities with more services, such as neonatal intensive care units and pediatric subspecialists. Finally, Labor & Delivery staff members are highly skilled and must maintain their proficiency by assisting with the delivery of a steady stream of babies."

Dr. Danzy offered an additional perspective about why maternal care is disappearing in rural areas.

Danzy says, “Decreasing volume, decreased revenue, increase in expenses and liabilities. Retention and recruitment (physicians and nursing) quality concerns. Decreased Medicaid eligibility and decreased Medicaid expansion. Patients not being able to or not willing to go to DSS to sign up for Medicaid. Lack of surgical and anesthesia coverage which is needed for epidurals and cesarean sections. Fewer primary care physicians admitting to their local hospitals."

A possible financial solution?

Expanding Medicaid, offering incentives to rural doctor and offering mother care online.

Our investigation is ongoing.

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