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Bonner General Health shutters labor, delivery services

Hagadone News Network | March 18, 2023 1:30 PM

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 in Sandpoint 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, including loss of pediatrician coverage in the area and changing demographics.

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, Bonner General Health 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.

Hospital 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 hospital delivered 265 babies and admitted less 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," Bonner General officials said.

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

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

Bonner General 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 said.

In an episode of "This American Life" podcast, Dr. Amelia Huntsberger, with Sandpoint Women's Health, 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. She told the podcaster that when Roe V. Wade was overturned, 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 "This American Life" 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, while some 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, Owen 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 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 life-saving care. And I'm like, 'Well, yeah, but the road to hell is paved with good intentions.'"