LANCASTER, N.H. (AP) – Coos County will have just one hospital delivering babies after April 1, when the maternity ward at Weeks Medical Center is set to close.

Hospital officials say declining birth rates and escalating costs prompted the decision, which is expected to displace about 100 women in the first year and about 70 per year in the next few years.

CEO Scott Howe said as the number of deliveries decreased, the hospital still faced significant fixed costs – liability insurance, full-time nurses, equipment, beds and a doctor on call at all times. Because staffers delivered babies infrequently, they required expensive training programs to remain prepared for rare medical emergencies.

At the same time, the number of patients covered by Medicaid increased, while the state’s reimbursement rates remain stagnant. The hospital loses about a quarter million dollars a year on its obstetrical service and was projected to lose three times that amount in the next five years if the unit stayed open, How said.

“Sixty-plus percent of our births were Medicaid, and the state’s payment rate is just inadequate,” Howe said. “If Medicaid was willing to pay more to ensure access, then maybe we would have been able to do something different.”

The closure at Weeks comes five years after Upper Connecticut Valley Hospital in Colebrook closed its birthing unit. The county’s only hospital with a maternity ward will be Androscoggin Valley Hospital in Berlin, with Littleton Regional Hospital in Grafton County the next closest option.

Local leaders and state officials worry that poor and pregnant women will be left stranded without convenient options for care, and that the health of both mothers and babies could suffer.

“We may see them later in their pregnancy. We may see them after they’ve had the option to do certain testing. We may see them not at all during their pregnancy, and that’s a problem,” said John Sauter, who’s been practicing obstetrics in Littleton for 30 years.

Dr. Jerry Schlacter, an obstetrician at Dartmouth-Hitchcock Manchester and state chairman of the American College of Obstetrics and Gynecologists, said he also worries that distance will prevent women from seeking care.

“I know patients, if they really have to travel, they’re going to have fewer visits and their care won’t be as complete.”

The hospitals in Lancaster and Colebrook are trying to coordinate with their southern peers to provide some prenatal services closer to home. An obstetrician from Berlin started driving to Colebrook a few times a month for prenatal visits, and Weeks is in talks to provide similar services in Lancaster. But deliveries will still require a trip south.

According to hospital estimates, the closure of the Lancaster maternity ward will displace about 100 women in the first year, a number that is expected to decline into the 70s in the next five years.

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Information from: Concord Monitor, http://www.cmonitor.com

AP-ES-02-10-08 1147EST