Birth professionals lament labor unit closures

When Aleisha Ballew Silvers She was embraced by love when she gave birth at Blue Ridge Regional Hospital, Spruce Pine.

“It felt like being surrounded by older sisters who would help you, cheer for you, help you learn to breastfeed, teach you to care for your newborn and let you know that the experience belongs to you,” Silvers says. Silvers trained to be a labor and birth nurse and was eventually hired by Blue Ridge Regional Hospital. Her family has lived in Burnsville for many years so it felt particularly meaningful.

“Labor and delivery nursing is a calling, not a job,” Silvers explains. “We witness miracles. We are involved with the whole family, helping the mother, watching a man become a father, seeing a family forming before our eyes.”

Jamie Pate Burnsville was also a labor and birth nurse for Silvers at Blue Ridge Regional Hospital. She is proud to recall their services. “We had water labor, a bathtub for hydrotherapy and cordless monitors so we could watch the baby’s heart rate while the mom relaxed in the tub,” Pate explains. “More relaxation means no epidural, and relaxation can expedite the labor process.”

Blue Ridge Regional Hospital in Mitchell County shut down its labor and delivery unit and consolidated the services at Mission Hospital McDowell, Marion in McDowell County.

“We were like a family at Blue Ridge,” laments Silvers, remembering how when her third child was born, the hospital CEO sent her flowers. “When one of us hurt, the others prayed for each other. We watched each other’s kids and delivered each other’s kids. We were like a family. Not having that for our community breaks our hearts.”

Blue Ridge Regional Hospital was the sixth to close labor and delivery units across WNC in 2015-22. According to the, Closures began when Transylvania Regional Hospital, Brevard, Transylvania County, ended labor and delivery services. Patients were transferred to Mission Hospital, Asheville, Buncombe County. Transylvania Times. Charles A. Cannon Jr. Memorial Hospital Linville, Avery County closed its labor-delivery unit in 2015. Avery Journal Times reports.

According to The Blue Ridge Regional Hospital, its labor and delivery unit was closed in 2017, as well as Angel Medical Center, Franklin in Macon County. WLOS. 2019 saw the closure of Erlanger Western Carolina’s labor and delivery unit in Murphy, Cherokee County. Blue Ridge Public Radio reports. The Western North Carolina Birth Center, Asheville, was closed in 2021.

Eight labor and delivery units are available in Western North Carolina’s 18 counties.

Silvers states that labor and delivery unit closures are often due to financial reasons. These factors are not good news for health care providers, who love their work in the field. “It felt like we had a major death in our family,” she says.

‘Having a child up here is challenging’

Blue Ridge Partnership for Children released the Mitchell and Yancey Counties perinatal survey assessment, which was conducted by Blue Ridge Partnership for Children in 2021 to examine the effects of Blue Ridge Regional Hospital’s labor and delivery closure. The survey was completed by 176 mothers who were notified of it through a Facebook group.

Researchers Molly Rouse, Natalie Monaghan Heather Dawes Mothers who were surveyed reported greater anxiety over the unknown of travel, remote care providers not being readily accessible, and lack of coordination among care providers. “The closure of L&D at BRRH [Blue Ridge Regional Hospital] has increased the risk for poor birth outcomes in Mitchell and Yancey counties, particularly for mothers experiencing poverty, substance use disorders, alienation or isolation,” the survey assessment asserts.

Rouse didn’t know that Burnsville would soon be a long distance away from her home when she did the study. After the June birth of her third child at home, Rouse experienced a postpartum bleeding. Rouse believes she could easily have driven to Spruce pine, 20 minutes from Burnsville, if labor and delivery had been possible.  Instead, she says, “I got helivac’d out of the valley to Asheville.”

She continues, “My husband drove to the hospital as I flew there, with my mom in the car and my newborn baby strapped into a car seat, just a few hours old.”

Rouse, who is certified by DONA International as a postpartum Doula, was disappointed. “It did not need to be an emergency or treated that way,” she says. “And it wasn’t the way I wanted to spend my baby’s first 24 hours.”

Rouse was discharged from the hospital and sent to Mountain Area Health Education Center, Asheville, for a checkup. This meant Rouse had to make another trip down the mountain. Rouse knew she could self-advocate to find a local provider. “Even though I know how to navigate the system, having a child up here is challenging,” Rouse says.

Transportation can also pose a major barrier for birthing mothers. A 2020 study, Navigating Perinatal Care in Western North Carolina: Access for Patients Providers, by Carol C. Coulson and Shelley Galvin In the North Carolina Medical Journal Rural WNC has a shortage of labor and delivery services.

“Women had to drive 29 miles on average,” the study says. “Twenty-nine miles of serpentine mountain roads is not a short, half-hour trip even in the best weather with a reliable vehicle.” It notes how the terrain can be “challenged by rock slides, flash floods, ice and snow.”

These problems plague families at a time when they should be celebrating joy and being sacred, says Pate.

“You’re not medically sick if you’re pregnant,” she explains. “Moms should be able to deliver close to home and not have to travel while having labor pains.”

‘Important moments’

Blue Ridge Regional Hospital labor and delivery nurse, who worked previously at the hospital, would like to see more options for mothers and their babies in all 18 WNC county.

“We need a birthing center with midwifery and natural childbirth here, in close proximity to the hospital, if someone needs medical attention immediately,” Pate says.

Most importantly, nurses agree that communities want their labor and delivery services back in order to take care of one another again.

“Working in labor and delivery means we are there for the most important moments in family life,” Silvers said. “A small-town hospital can be so important to a family. We are Southerners. We take care of each other because it is the right thing to do.”