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BGH shutters labor, delivery services

by CAROLINE LOBSINGER
Staff Writer | March 18, 2023 1:00 AM

SANDPOINT — Soon, women about to give birth in Bonner County will need to drive to Coeur d'Alene or Spokane to have their baby.

Friday, Bonner General Health announced the hospital would no longer be offering labor and delivery service at the 25-bed hospital. While it will attempt to provide service through May 19, that will depend on staffing.

"We have made every effort to avoid eliminating these services," Ford Elsaesser, Bonner General Health board president, said in a news release. "We hoped to be the exception, but our challenges are impossible to overcome now."

The decision was not easy and came down ultimately to several factors, loss of pediatrician coverage in the area, changing demographics and the state's legal and political climate.

Hospital officials said highly respected, talented physicians are

leaving the area and the state due to Idaho's legal and political climate, citing it as one of the reasons behind the move.

"Recruiting replacements will be extraordinarily difficult," officials said in the press release.

With the Idaho Legislature introducing and passing bills that criminalize physicians for medical care that is nationally recognized as the standard of care, BGH officials said doctors are reluctant to move to Idaho and many are leaving. Consequences for Idaho physicians providing the standard of care may include civil litigation and criminal prosecution, leading to jail time or fines.

With OBs willing to take that risk, BGH officials said their only option was one they hoped would never take place: Shutter the hospital's labor and delivery services.

"[Our] commitment to patient safety drives our decisions in the available services we can provide to our community, even with the most challenging choices having to be made," Erin Binnall, the hospital's public information officer, said in the release. "Therefore, [we have] made the emotional and difficult decision to discontinue providing obstetrical services."

The hospital will be unable to provide pediatrician coverage to manage neonatal resuscitations and perinatal care on a consistent basis as of May. That makes it unsafe and unethical to offer routine labor and delivery services. The hospital has reached out to active and retired providers for help with pediatric call coverage, but has been unable to come up with a long-term, sustainable solution.

With an aging population, the number of deliveries at Bonner General has steadily declined. In 2022, the BFH delivered 265 babies and admitted fewer than 10 pediatric patients.

"There are many reasons, including a nationwide decrease in births, an older population moving to Bonner County and Kootenai Health having a new, updated unit with neonatologists and OBs in-house 24/7," BGH officials said.

Moving forward, BGH officials said the hospital will continue to provide women's health services at Sandpoint Women's Health and will collaborate with Kootenai Health to provide OB care in the community.

However, Sandpoint Women's Health is no longer accepting new OB patients, effective immediately.

BGH officials thanked residents for trusting their doctors and labor and delivery staff with their care, and would help them coordinate future care.

"The closure of obstetrics will not be an easy transition for our Bonner General Health teams or our community and surrounding area," they added.

In an episode of "This American Life" podcast, Dr. Amelia Huntsberger told the interviewer that as a general OB/GYN, she saw everyone from teens to women in their 90s, and provided everything from breast exams to delivering babies. When Roe v. Wade was overturned, she told the podcaster that her first instinct wasn't to leave, it was to fight.

She joined committees, reached out to other OB/GYNs and testified before the Idaho Legislature regarding the state's abortion law.

She told the "This American Life" interviewer that things began to change when she had a patient with an ectopic pregnancy. Then another when the ectopic pregnancy ruptured.

"Do these people understand how serious this condition is, or do they only understand that I removed a pregnancy that had a heartbeat?" she told the interviewer. "I don't know. How am I supposed to know?"

Dr. Deb Owen, who operated Sandpoint Women's Health along with Dr. Bruce Honsinger from 2001 to 2011, said rural states were already a tough sell because hospitals there can lack the latest equipment and specialists. Now, OBs are in even higher demand and have their pick of hospitals — and states — where they can choose to practice.

Owen, who still lives in Bonner County but practices at a Spokane area hospital, said the new OBs are no longer willing to be on call every night or every other night. Recruiting for those positions – often located in rural areas — was always difficult. Now, with the political climate, OBs are looking to leave the state and none are willing to move to Idaho.

"We all have our own, behind-the-scenes grapevine and everybody's having trouble recruiting to the states with more restrictive laws," Owen said. "[Most of the new doctors] are just horrified at the prospect of moving to any kind of state with this kind of politics. They're just like, why would I want to do that when there are thousands of jobs in states where I don't have to worry about that."

At least several doctors have left the state; others are quietly discussing it among themselves or with trusted friends. Many others are either looking for positions or have found a position and are just waiting for their certification to come through.

The risk of criminal charges, of losing their medical license and being unable to provide women with medically necessary care outweigh the rewards of living in an area they love and being able to serve their community, she said.

Now, doctors can't take care of patients with high-risk, complicated pregnancies who are in danger of bleeding to death or dying from infection, where a pregnancy with legal anomalies has to be carried until the child is born.

"Should I commit malpractice? Or should I commit a felony? I don't know which one I should do," Owen said of the dilemma facing OBs. "So in order to get out from under that, people are leaving the state."

Many she's talked to are horrified, saying doctors being unable to help women with life-threatening complications was not what they wanted.

"We just really wanted to codify the law so that you nobody who has irresponsible sexual activity feels like they can just go out and terminate their baby because it's inconvenient to be pregnant," Owen said of some of the comments. "We didn't really intend for the law to, you know, prevent my sister from getting lifesaving care. And I'm like, 'Well, yeah, but the road to hell is paved with good intentions.'"