Talk about no room at the inn.

Pregnant moms in much of Philadelphia stand a better chance of delivering their babes in barns than in a neighborhood hospital.

Thirteen maternity units have closed in the Philadelphia area since 1997. In November, maternity units at Brandywine Hospital, near Coatesville, and the Central Montgomery Medical Center in Lansdale also closed.

The latest threat to the well-being of women and their babies is the possible reorganization or even closure of Northeastern Hospital, which has been the last option for women in the Lower Northeast.

The Port Richmond hospital, at 2301 E. Allegheny Ave., has been part of the Temple University Health System since 1995. It primarily serves Port Richmond, Kensington, Frankford, Fishtown, Nicetown and Bridesburg.

Temple managers told staff last month that the health system intends to dramatically restructure Northeastern Hospital as the community has come to know it. One possibility is that Temple could eliminate maternity and other services, offering only an urgent care center and some outpatient facilities, as it does at its Episcopal Hospital campus.

Other hospitals in the system include Temple University Hospital and Jeanes Hospital in Fox Chase, which closed its maternal-care unit in May 2007.

At that time, TUHS also shuttered an adult day-care program at Northeastern and the school of nursing at the TUH-Episcopal Campus.

Northeastern Hospital lost $6.6 million in fiscal year 2008, and is projected to lose more in 2009, according to TUHS spokeswoman Rebecca Harmon.

“Such losses are not sustainable,” Harmon said.

TUHS has organized a task force composed of 12 key administrators within the health system to study its options. Harmon said it was premature to talk about what those options might be.

“Another important point is that all the recommendations put forth will take into consideration the community, the medical staff and the employees,” Harmon said.

Dr. Albert Pizzica, director of newborn nurseries and chief of pediatrics at Northeastern, hopes the task force and the health system won’t abandon its mission.

In the past five years, TUHS has received $120 million in enhanced government support, state funding given specifically to aid TUHS in its role as a safety net for the city’s poor and under-served. That support is above and beyond what most other hospitals receive. More than $27 million of that funding was earmarked for Northeastern Hospital.

Pizzica is concerned about the resulting public health crisis for pregnant Medicaid moms if Northeastern ceases maternity services.

“This is the last community hospital. We’ll deliver 1,800 this year alone. There is no capacity for anyone to absorb this. Where would these mothers go?” he asked.

Should Northeastern close its obstetric unit, the remaining options in the city are Albert Einstein Medical Center, Hahnemann University Hospital, Hospital of the University of Pennsylvania, Pennsylvania Hospital, Temple University Hospital and Thomas Jefferson University Hospital.

Only three of the city hospitals are available to patients on AmeriChoice, one of three Medicaid insurance programs.

Many Northeast Philadelphia women chose to deliver outside of the city, at Holy Redeemer, Abington and Lower Bucks hospitals.

In labor and without a car, however, women can find their options are severely limited. In the view of Bette Begleiter, deputy director of the Maternity Care Coalition, an advocacy group, that offers the potential for problems.

“If you don’t have a car, go into labor and call 911, they’ll take you to the nearest hospital. They may not have any of your records, and not be the hospital you’ve been seen at,” Begleiter said. “It only intensifies the problem.”

Pizzica agrees. During the weekend of Dec. 20, he had two mothers-to-be walk in, eight weeks’ premature.

“They never would have made it to Einstein or Temple. They would have delivered on the street,” Pizzica said.

Pizzica was a neonatologist at Episcopal for 18 years before its obstetric unit closed. At Northeastern since 2002, he wants to make enough noise early enough to sway members of the Temple task force not to close the hospital or its maternity unit.

“We really have to mobilize now. Once Temple makes this decision, it will be hard to reverse it,” he said.
It’s all about dollars and cents.

“Philadelphia is a very challenging market for health care, magnified by the national financial crisis, which has affected all businesses and industries,” said TUHS spokeswoman Harmon. “For the past several years, Northeastern and TUHS have posted losses we just can’t continue to sustain.”

The Pennsylvania Association of Staff Nurses and Allied Professionals held a candlelight vigil and rally on Monday, Dec. 22, to protest any TUHS plan to eliminate vital services at Northeastern.

The Maternity Care Coalition has worked for years to bring a looming and now ever-present crisis in care for pregnant women and their families to the attention of stakeholders and politicians.

During a recent phone interview, Begleiter echoed the coalition’s goal.

“The bottom line for us is that maternity care must be made profitable or ensure enough regulations that hospitals are required to provide for women to give birth,” she said. ••