Dr. Max Rogers doesn’t want to sugarcoat the fallout of closing one of the last labor and delivery departments in rural southwest Alabama.

An obstetrician/gynecologist at Grove Hill Memorial Hospital, Rogers once used euphemisms to describe what might happen if the small hospital ended the service. Now that the closure is set for Aug. 16, he wants to state his predictions clearly.

“I used to say, ‘poor outcomes,’” Rogers said. “I’m just going to tell it like it is. That means that babies are going to die, and mothers are going to die because we’re not going to have any obstetrical expertise to take care of them.”

Grove Hill Memorial Hospital on Wednesday announced the closure of its labor and delivery department. The facility sits in rural Clarke County, a good 90 minutes north of Mobile or two hours southwest of Montgomery. It is the last hospital in rural southwest Alabama still delivering babies.

Grove Hill Memorial Hospital this week becomes the latest rural hospital to announce plans to reduce inpatient care in order to convert to a Rural Emergency Hospital. The federal Rural Emergency Hospital program is a lifeline to keep hospital doors open, but it also has a cost, including labor and delivery.

Grove Hill is one of four Alabama hospitals who have filed notices they will convert to REH. Bullock County Hospital, East Alabama Medical Center-Lanier and J. Paul Jones Hospital in Camden have all signaled their intent to make the switch.

Meanwhile, around Grove Hill in southwest Alabama, other labor and delivery services are closing. Monroe County Hospital one county over ended its obstetrical services last year. Whitfield Regional Hospital in Demopolis suspended its labor and delivery services in May with plans to reopen in September. The closest hospital to Grove Hill where women can deliver babies is in Brewton, and that’s about 80 minutes away.

“I’m going to paint you the worst-case scenario,” Rogers said. “I don’t want to be accused of being hyperbolic or exaggerating, but in a worst-case scenario, these women are not going to be able to get to Mobile or Selma or Montgomery or Tuscaloosa, which are the only other areas around.”

When Monroe County Hospital closed its labor and delivery department in November, he said, some of those patients turned to him and the patient count for his practice increased by 35 percent. All those patients will have to find other doctors and labor and delivery centers.

Rogers said many patients are low-income and struggle to find transportation to pre-natal appointments. Friends and family members must take off work to drive them to the doctor or hospital. Some will not be able to keep appointments that are more than one hour away.

The March of Dimes, an organization that advocates for newborn health, found that the percentage of people in Alabama who live more than 30 minutes away from a hospital with a birthing center is three times higher than the national average. The same organization gave Alabama a grade of F for preterm births.

Rogers is not just an obstetrician, he is also the chairman of the Alabama Board of Medical Examiners, the agency that regulates physicians in the state. He regularly meets with government and public health officials and advocates for the medical needs of rural women and children.

Rogers has lobbied city, county and state leaders to save the labor and delivery department. The service loses money, and government leaders have not been willing to provide enough funds to make up for those losses, he said.

At one city council meeting, he appealed to the leaders of Grove Hill. City leaders said they couldn’t provide funding for one line of service at the hospital, Rogers said. Then, 15 minutes later, they voted to add $20,000 in funding to the local animal shelter, he said.

“Listen, I love animals just like everybody else, but that is a devastating expose as to where our culture has attitudes about our pregnant women and our young,” Rogers said.

Rogers has said city, county and state leaders have all pointed fingers at each other when asked who should help support struggling hospitals.

Hospitals that seek Rural Emergency Hospital status get monthly payments of $267,408.68, according to the Centers for Medicare and Medicaid Services. Those hospitals must operate emergency departments 24 hours a day, 7 days a week. They can’t provide inpatient care, including labor and delivery.

Women who had planned to deliver at Grove Hill Memorial Hospital will have to make new arrangements as their due dates approach. Rogers said he is worried about the women in his community, and how they will fare after the department closes.

“I don’t know what the body count is going to be, but there are bleak days ahead,” Rogers said.