The Philadelphia Inquirer on Sunday examined reasons behind the closure of 11 hospital maternity wards in Philadelphia in the past decade, which has left hospitals that do deliver infants "scrambling to find more space and staff." Experts said that high expenses for malpractice insurance and relatively low reimbursements from health insurers have caused maternity care to be a "money loser" for most hospitals, the Inquirer reports.

Malpractice insurance for ob-gyns in the Philadelphia area costs about $160,000 annually, according to the Medical Liability Monitor. Some hospitals are self-insured, and facilities with a large number of Medicaid beneficiaries receive extra funds from the state; however, some hospital officials said the aid still does not enable them to break even on maternity care.

The Hospital and Healthsystem Association of Pennsylvania in response to the closings is proposing a state-supported "obstetrics stabilization fund" that would increase Medicaid reimbursements for intensive care for pregnant women and infants, the Inquirer reports. The group also is lobbying for state assistance in reducing malpractice insurance costs. In addition, the Maternity Care Coalition, a Philadelphia-based group that advocates for pregnant women and young children, is urging Pennsylvania to identify hospitals that have shortages of obstetricians and provide them with extra funding. The coalition also is calling for increased Medicaid rates and state and public involvement in maternity ward closure decisions (Burling, Philadelphia Inquirer, 5/6).