National Nurses United

National Nurse Magazine April-May-June 2022

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the hospital corporation cites those lower birth rates as rationale for the closures. It's not just California. Since 2010, Illinois has lost at least 16 labor and delivery units; 11 of those closures happened in neighbor- hoods with levels of child poverty far higher than the state average, including three where the percentage of children living in poverty was more than double the state average. In 2018, the South Side neighborhood of Chicago, a community that is 93 percent Black, had six ob/gyn units. By the end of 2021, that number had dropped to just three. Among those shuttered, the labor and delivery unit at Jackson Park Hospital. "I was heartbroken," said Yulanda Clark, who worked in Jackson Park's labor and delivery unit. "I thought it was really a loss to the community, the women, we serve. I really believe that we offered them high-quality care." Tresury Blake-Marlow gave birth to her daughter at the hospital and has received care there since she was a child. "When I walk in the door, they know my name," Blake-Marlow said at a town hall meeting in 2019. She noted how much she appre- ciated the all-Black female staff, "When I'm there I feel comfortable. It's good to see people who look like you." Clark notes that because the nurses and doctors who worked in her labor and delivery unit were almost exclusively Black, they were culturally competent to care for their patients. "We understand them and are empathetic to them." That trust, bond, and rapport— which is always essential to nursing care—is even more critical during an experience as intimate and vulnerable as childbirth. Clark said while there had been mumblings of the unit closure for years, the nurses were surprised that it came just a few years after the hospital spent $4.6 million in state grants to renovate and expand the labor and delivery unit. "Why would you invest so much in this state-of-the-art facility and not utilize it?" said Clark. As the nurses fought to keep the unit open, they found that the majority of households in the surrounding area didn't know about the renovations. Clark questioned why the hospital spent millions in taxpayer money but then failed to inform the community, "It made no sense at all." R egistered nurses, whose medical expertise and practice is grounded in a deep knowledge and understanding of their patients and community, are not just worried about birthing emergencies resulting from unit and hospital closures; they are afraid for their vulnerable Black, Brown, and low-income patients now facing new, routine challenges as ob/gyn services are cut and shuttered. Hovie said many parents who don't have easy access to transpor- tation, or who are scraping by, will skip important prenatal care that many patients received at Redwood Memorial's birthing center. "Some of them are absolutely struggling to find a ride into the hospital, finding gas money, and now we've put this greater bur- den on them," Hovie said, adding that some patients will now have to take a day off work to travel to get tests or care, where pre- viously they could get to the birthing center and be seen within an hour or two. "How do you decide: Do I pay my rent and feed the kids I already have or deal with something that I can't see and I can't touch and they're telling me maybe it's a problem, or maybe it's not?" When Jackson Park announced its labor and delivery closure, doctors and nurses fought to keep the unit open, worrying about how the many patients who walked to the hospital or who used pub- lic transportation would be able to access services. Zeman worried that when Regional closed, the hospital's low- income and immigrant patients from East San Jose would not be able to get care anywhere else. 26 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G A P R I L | M AY | J U N E 2 0 2 2

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