A report on AL.com points to the alarming fact that only 17 out of 54 counties in Alabama contain hospitals where a woman can deliver a baby. This is a sharp decrease from 1980, when 46 out of 54 counties in the state offered L&D services.
For background on this situation, the article cites the significant expense of maintaining obstetrical services at a hospital: labor and delivery departments come with additional insurance complications, both for patients and doctors. As a result, many smaller hospitals have shuttered these services, creating a situation in which women are increasingly scheduling inductions and C-sections or delivering at the ER. Safe home birth has been made, for some reason, effectively illegal:
If they choose to deliver at home, state law forbids them from being assisted by a midwife or other skilled provider.
AL.com also cites an Alabama Rural Health Association statistic from 2013 that found that "nearly 26 percent of expectant mothers in rural areas in Alabama received less than adequate prenatal care." This is an overwhelming systemic tangle, but a good place to start might be letting midwives do their damn jobs.
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