Brookwood Baptist Health will close two labor and delivery units in the Birmingham area next month, dealing another blow to pregnant women in a state where long drives for prenatal care have become increasingly common.

A spokesperson for Brookwood Baptist Health said the obstetrics departments at Shelby Baptist Medical Center in Alabaster and Princeton Baptist Medical Center in Birmingham’s West End will close after Oct. 25. Shelby County – sixth largest in Alabama with more than 230,000 people – will become the largest county in the state without a labor and delivery department.

“Maternity services will remain available at Brookwood Baptist Medical Center and Walker Baptist Medical Center,” wrote spokesman David McKinney in a statement. “We are grateful to the obstetrics department staff and physicians for their continued commitment to provide our patients with outstanding care. Their professionalism and skill have helped create cherished memories for countless families over the years.”

More than a third of Alabama counties are classified as maternity care deserts, according to the March of Dimes. Closures of labor and delivery units have left 25 of the state’s counties with zero access to prenatal and delivery care. Hospitals have been shutting down labor and delivery units for years, but the pace has increased since 2018, when March of Dimes began tracking the closures.

Closures often affect rural areas. In Alabama, some women drive more than 70 miles to reach hospitals with labor and delivery services. About 28 percent of Alabama women live more than 30 minutes from the nearest hospital with a birthing unit, compared to 9 percent nationwide, according to the March of Dimes.

Neither Princeton Baptist nor Shelby Baptist is considered a rural hospital. But the closures will affect patients in the city of Birmingham and its suburbs, said Dr. Elizabeth Sahlie, a pediatrician who practices at Princeton Medical Center.

In recent years, the pediatrics and obstetrics departments at Princeton had worked hard to improve care for mothers and babies. Practitioners offered group prenatal care and incorporated nurse midwives, who had the ability to provide prenatal care and attend deliveries, Sahlie said.

“As a result of that, we saw improvements in our outcomes,” Sahlie said. “We had big reductions in out C-section rates and increases in our breastfeeding initiation rates.”

According to the 2020 birth statistics from the Alabama Department of Public Health, Princeton Medical Center had the lowest cesarean section rate in Jefferson County. It is the only other hospital in the county besides UAB to be designated as Baby Friendly, which means staff are specially trained to support breastfeeding.

“I think it’s going to reduce the choices that people have and the type of birth experience that they want to have. I think it’s a tragedy for people who were seeking out that particular model.”

Dr. Jesanna Cooper worked with Sahlie on many of the changes at Princeton. She said it had always been her dream to work at a hospital with Baby Friendly certification and she was elated when the staff achieved it. During 10 years at the hospital, she said the number of deliveries increased as mothers sought out care from midwives and other special services. Still, Princeton had fewer births than many of the surrounding hospitals.

“It created a culture where we were able to do low risk births and high-risk births in a patient centered and woman-centered way,” Cooper said. “It’s less cookie cutter, and part of the reason was because we were small.”

Cooper left Princeton in December, but said she was emotional at the news of the department’s closure. She said she thinks the company that owns Brookwood Baptist Health, Tenet Healthcare, probably made the decision to end the service several years ago.

“If you look at how for-profit healthcare tends to work, they do not invest in communities of color and they do not invest in communities of lower socio-economic status,” Cooper said.

Birth outcomes in Alabama are among the poorest in the country. The state has high rates of infant and maternal mortality, especially among Black mothers and babies. A large percentage of pregnant women in the state have conditions such as diabetes or high blood pressure that make pregnancy more dangerous to mothers and babies.

Financial pressures have forced many hospitals to cut labor and delivery services. About half the births in Alabama are funded by Medicaid, which pays hospitals lower rates than private insurance.

Brian Binzer, city administrator for Alabaster, said the company informed him recently labor and delivery service would be ending in Shelby County. It was a business decision made by the hospital’s owners, he said.

“The city is disappointed that this longstanding service in our community is going to be discontinued in October,” Binzer said. “It’s one service we hate to see go, but we understand they have to make a call on that.”

Binzer said other investments have been made in the hospital and the emergency room will be well-equipped for obstetrical emergencies. Many women in the area already travel to Jefferson County for care, he said.

“There will be some impacted families that were expecting to have babies here in Alabaster and that’s unfortunate,” Binzer said. “It’s something we’re disappointed about. But again, it’s not the city’s decision, it’s ultimately the hospital’s decision.”