The Status of Obstetrics Access in Southeastern Pennsylvania

14 OB units have closed since 1997

Closing obstetric units (OB units) have contributed to local spikes in occupancy rates and raised concerns around the capacity of remaining units to serve women safely. Women also face an additional barrier in that the nearest OB unit may not accept their insurance plan. 

Closing OB Units

There is an alarming trend of diminishing birthing options for pregnant women in Southeastern Pennsylvania. 

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Capacity Concerns for OB Units

Regional OB Unit Capacity charts show the occupancy rate in 1996 compared to 2006 for Bucks, Chester, Delaware, Montgomery and Philadelphia counties.  Capacity is an area of concern for practitioners and families. The literature recommends a capacity around 75% and, in 2006, 4 of the 8 remaining OB units in Philadelphia were operating above this capacity; one at 107.5% (Table 13)! 

Furthermore, anecdotal evidence suggests that OB practitioners and hospital staff are overwhelmed and patients are frustrated about overcrowded facilities and traveling further distances to receive care. 

The Philadelphia Department of Public Health commissioned a Drexel University report, "Obstetric Care for Philadelphia Residents: 1997-2004."  The following is an excerpt:

Individual hospitals make their own determinations as to what occupancy level they are comfortable with, taking into account fiscal pressures, risk, and provider workload. Several states and organizations have published “ideal” obstetric occupancy rates, sometimes varying for urban and rural areas or small vs. large hospitals.

Table 13 citations:

New York State Department of Health: Acute Care Facilities

Illinois Health Facilities Planning Board (03/21/2005)

Department of Defense Planning Criteria for Health Facilities

"Strategies for Cutting Hospital Beds: The impact on patient services"

Excerpt courtesy of report author:

Jennifer Kolker, MPH
Assistant Professor
Drexel University School of Public Health Department of Health Management and Policy

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The Insurance Labyrinth: Which OB Units Accept which Medicaid Insurance Plans

The table below shows that 6 of the 8 remaining OB units in Philadelphia take all three Medicaid managed care plans (HealthPartners, Keystone Mercy, and AmeriChoice).  As of July 1st, 2007 the Hospital of the University of Pennsylvania and Pennsylvania Hospital began accepting AmeriChoice.  Albert Einstein Medical Center and Thomas Jefferson University Hospital stopped accepting AmeriChoice for new patients.(AmeriChoice patients will either need to change hospitals or their Managed care plan.)

MCC'S Childbirth at a Crossroads report offers recommendations on reversing this trend.  After reading the report, share your experiences, great ideas, comments, or questions by emailing mcc@momobile.org!

Learn more about prenatal care access concerns in Philadelphia and Norristown.

Please visit our Childbirth Crisis News page to read recent articles covering the issues brought up in our Childbirth at a Crossroads report. 

Community Engagement

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