SILER CITY — When Chatham Hospital’s $2.6 million Maternity Care Center officially opened in September, it was a milestone for Siler City and the county — marking the first time in nearly 30 …
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SILER CITY — When Chatham Hospital’s $2.6 million Maternity Care Center officially opened in September, it was a milestone for Siler City and the county — marking the first time in nearly 30 years that Chatham had its own maternity ward.
And it put Chatham in a unique position, bucking the trend as rural hospitals shuttered across the country.
The maternity center’s creation at the hospital — located on Progress Boulevard in Siler City and part of the larger UNC Health Care system — was a strategic element of the facility’s expansion. It comes along with projections of continued population growth across the county, especially in Pittsboro, where the town’s population is expected to swell 10-fold over the next 20 years as young couples and families move into Chatham Park and other growing neighborhoods in the county’s northern section.
The MCC’s opening is the first time since 1992 that Chatham Hospital has operated a maternity ward, but it comes at a precarious time in the evolution of America’s healthcare services industry. Besides opening during a pandemic that has strained medical facilities, the unit arrived amid a larger industry crisis — small-town hospitals are closing with increasing frequency as rising operations expenses outpace hospital revenue.
That was the reason the old Chatham Hospital discontinued its maternity care 28 years ago, hospital leaders say, and it’s the reason why at least 10 rural communities in North Carolina lost their labor and delivery services in the past decade.
“By and large, rural hospitals are suffering,” said Kristen Coleman who manages Chatham’s Maternity Care Center and serves as a nurse. She joined the staff in Chatham to oversee the new operation after working for 12 years at Randolph Hospital, where she often assisted Chatham mothers.
“Before we opened up here,” Coleman said, “for anyone who lived near Siler City, the shortest they could go was 30 minutes to Randolph.”
From other parts of the county, mothers had to drive an hour or more to give birth. Besides inconveniencing them, such distances posed serious problems to the mothers’ and babies’ health.
“It was a big issue; there was really a need for the community,” Coleman said, “because it was kind of a safety issue really.”
Dr. Dana Iglesias, the Maternity Care Center’s medical director, sees the issue as a matter of life and death. After 18 years focusing on maternity care, she has witnessed an incontrovertible fact: the farther mothers must travel to deliver their babies, the higher their chances for complications.
“There are a higher number of births outside of hospitals when rural units close down,” she said, “and that translates to issues … There’s a birth crisis in America. More mothers are dying, but women shouldn’t be dying for preventable reasons with all the technology we have. So, this is really good for Chatham.”
The addition within Chatham Hospital’s building was made possible by Chatham Hospital’s affiliation with the UNC Health Care system, a not-for-profit integrated care network owned by the state of North Carolina and based in Chapel Hill. UNC Health Care includes UNC Hospitals, clinical programs of the UNC School of Medicine, plus 11 affiliate hospitals and hospital systems across the state. At Chatham Hospital, the county’s health department and Piedmont Health Services also contributed to the project’s success and its world-class facilities.
While rural hospitals often suffer from underfunding and outdated technology, Chatham’s Maternity Care Center works to offer new mothers an unparalleled care experience, albeit with limited capacity. Expecting mothers are invited to tour the facility before delivery, and so far, none have been disappointed.
“People are always surprised,” Iglesias said. “They say, ‘I don’t know what we were expecting in a rural hospital, but this is lovely.’”
Unlike at some hospitals where the delivery and recovery processes are spent in different rooms, Chatham Hospital cares for mothers in private suites for the duration of their stays. The large rooms are clean, but inviting — absent the sterile facade that makes some hospital wards disconcerting. The first-rate service and amenities have even attracted mothers from Lee and Wake counties and elsewhere beyond Chatham.
“One couple came to visit from Raleigh,” Coleman said, “and the husband said that the moment they walked through the door his wife said she was delivering here.”
Despite having only five maternity beds, the ward keeps 11 medical professionals on staff: one obstetrician, four family medicine providers with surgical privileges to perform C-sections, four non-surgical providers and two midwives.
“It’s the community feel and personalization that’s so special,” Coleman said. “We don’t have providers running around because of 10 deliveries going on at once.”
Before opening, the hospital set 10 deliveries as its monthly goal, and so far there has not often been more than one delivery at a time. Since September, 40 babies have been born at the center.
Not designed for high-risk births
While the Maternity Care Center will suit most expecting mothers’ needs, it is not designed to serve higher-risk patients.
“Mothers can’t have any preeclampsia or gestational diabetes nor fetal issues,” Coleman said. “We’re Level I, so we only have the ability to stabilize.”
The American College of Obstetricians and Gynecologists designates maternity centers according to three levels. Level I facilities, such as Chatham Hospital’s, offer basic care. Levels II and III are authorized to give varying degrees of specialty care.
“So, if something happens, but we can get mom stable enough,” Coleman said, “ideally we’ll transfer her to a bigger facility before delivery.”
For those births without anticipated complications, however, Chatham’s maternity ward offers a personal and intimate experience. Especially during the coronavirus pandemic, the care center’s private rooms afford families a more typical birthing experience than larger hospitals.
“The major thing is the visitation policy changed, but other than that COVID hasn’t changed much,” Coleman said. “They’re actually still allowed to have two visitors for the delivery.”
As the pandemic subsides and the Maternity Care Center reaches its goals, it will expand to support more frequent deliveries in coming years. By 2025, Iglesias and Coleman hope the facility can support 350 mothers per year.
But the maternity ward will never rival its nearby competitors for size — and that’s just how its leaders want it to be.
“Our size allows us to give the very best care,” Iglesias said. “This is where small is nice. Small is good.”
Iglesias has seen the gamut of maternity care facilities having worked in hospitals around the country and internationally. But she is proud to serve in Chatham’s Maternity Care Center where she can benefit a community that has been underserved for decades.
“This is a beautiful unit,” she said. “It’s been great. It’s been a lot of work, but it’s definitely been worth it to be able to serve this community after all this time without a (maternity) unit — to have an accessible unit that can support patients in their context.”
Reporter D. Lars Dolder can be reached at firstname.lastname@example.org and on Twitter @dldolder.
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