Contractions and Subtractions

Leslie Wolf lives on the coast of Maine, ten minutes from the hospital where her first baby is due in November. That hospital has delivered babies for 84 years, and it is about to stop. MaineHealth says there are not enough births in Lincoln County to pay for the doctors and nurses a delivery unit needs around the clock, so the unit closes, and Leslie's son could be one of the last babies born there.

It is happening all over the country. A new March of Dimes report found that more than half of the counties in the United States do not have a single hospital that delivers babies. Rural hospitals that lose money cut the delivery unit first, because it is one of the most expensive things they run, and in Michigan alone eleven small-town hospitals have shut theirs since 2010. The babies still arrive, but now the nearest place to have one is an hour or more away.

Your Task: Imagine you run a rural hospital, and you just signed the paper that closed its delivery unit.

1. The Backup, and What It Costs
The unit is closed, but babies do not stop coming, and some of them will not wait for a long drive. Pick the one thing your hospital keeps doing so a birth that happens anyway is safe. It could be an ER nurse trained to deliver, a deal with the county for an ambulance that is always ready, or a midwife clinic in the empty unit. Say what it is and who is doing that job at 3 a.m. on a Sunday. Then, because the hospital is losing money, name what it stops doing or does less of to pay for your backup, and who notices first. (5 to 6 sentences.)

2. Leslie's Question
At a town meeting, Leslie stands up and asks you what happens if she goes into labor at 2 a.m. in a snowstorm. Write your honest answer, the one you would actually say to her face, and include the one thing you cannot promise her. (3 to 4 sentences.)

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