Mary gave birth of urgency, a child’s “healthy and beautiful” in the regional hospital of Verín (Ourense), only a few days after that the Government took a decision unusual in Spain: close to the maternity area by a low birth rate and to suppress the pediatricians of the guard. When I was breast-feeding, she had a episode for the one who thinks “take legal action”: “The pediatrician that came from the hospital of Ourense I pulled him out and took him in a ambulance, saying he had to cover a few reports. Two hours later, when I I refilled something, led me to me. They put Me in the emergency room in a wheelchair and I had several hours waiting in a hallway of the appointments of gynecology, bleeding and with the epidural still on”.
The rugged birth of Mary is the first consequence of the closure of the emergency pediatric and birthing where they gave birth to women from 11 municipalities gallegos. The galician Government justified the closure on that in this hospital they were born in the past year 89 infants and wields a recommendation included in a guide of the Ministry of Health, 2009. The document considers “prudent” not to give maternity to those centres that do not exceed the 600 births a year, “except for reasons of travel times or accessibility to do so”. In Spain half a hundred public hospitals are below that annual number of births-including six of Galicia, aside from Verín – and many are private in the identical situation. None of the communities with the lowest records arises, however, to follow the path undertaken by the Government.
In Aragon, at least four public hospitals recorded fewer than 600 deliveries per year and the Jackfruit was left in only 124 in 2018. The regional Government (PSOE) is not planning to close any birthing because it argues that, though it takes account of “the convenience” of these services “have a specific number of deliveries per year to ensure the quality”, it is “also a priority” the “structuring of the territory” in a large community of widely dispersed population.
Protest before the Parliament to galicia by the closure of the birthing of Verín. or. corral
“If we want to fight against the depopulation, we must focus efforts on ensuring full and equal access to public services”, argue from Extremadura, a vast autonomy in the hospitals of Coria and Navalmoral do not reach the 600 annual deliveries. The Executive socialist believes that close their calving and impair their pediatric services as it has done Galicia would aggravate even the current difficulties to find professionals who want to practice there: “Would these hospitals less attractive to professionals, which will naturally seek a development of their professional career”.
The Government of the Valencian Community denies that there is a criteria established to close calving with fewer than 600 births, but only “recommendations”. “For us the main criteria is equity in access to health care”, they defend. In Asturias, with two centers that barely reach the hundred of births and which are close to large hospitals that Verín, Ourense, don’t think to close any service because, explains the responsible socialists of the Principality, working “in network” and sent to the professionals of the central areas to give assistance in areas more peripheral.
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Neither the government of Catalonia, with four hospitals under the 600 births a year, or the autonomies governed by the PP, like Madrid, Andalucia or Castilla-Leon, with three, seven and four centers, respectively, assisted by the Xunta. The Board castellanoleonesa argues that to keep open these rooms respects the right of the inhabitants of these areas, “a health care nearby and proper”, taking into account that, as was the case in Verín, these centres attend births “with a low risk of complications, including anesthesia”.
the president of the Xunta, Alberto Núñez Feijóo (PP), argues that the closure of the maternity of Verín, which includes the suppression of the pediatric emergencies, has driven in favor of the “safety” of women, by the loss of expertise of the professionals when the activity is low, and the babies, because “there are no pediatricians” who want to work in Verín. “I prefer to take an unpopular decision based on medical criteria, that put in risk the life of a mother or a baby,” he said.
The galician Government has received the support of the Paediatric Society of Galicia, that he has not seen “justified” keeping in Verín a service to attend low-risk deliveries with the shortage of specialists that suffers Spain. The Spanish Society of Neonatology disagree. “You can’t let helpless people living in rural areas; if you cut in health care, despoblarán altogether”, argues Max Vento, president of the European Society of Neonatology (European Board of Neonatology) and of the Spanish (SENeo). Recognizes that the experience of physicians is the main factor of success in any medical intervention but points out that the second is the immediacy of the assistance.
also principal investigator of the Group of Perinatology at the hospital The Faith of Valencia, points out that hospitals that do not reach the 600 annual deliveries that certify expertise in clinical terms “you need to find imaginative solutions and to change the stiff legal system in Spanish”. He asserts that the absence of pediatricians “can be solved with the anaesthetists, who can revive perfectly to a newborn baby”. And it states that this is “a lot easier than bringing a woman to give birth in a hospital 70 kilometres away ”.
The neonatologist puts the example of Canada. In the province of Alberta, more extensive than Spain, there are only two hospitals in size and the rest are county level. The lack of expertise derived from the few deliveries the taken care of “with the rotation, a couple of weeks, of all the doctors in the county to one of the large hospitals,” in which interventions are and are brought up to date on new techniques. To older, “will make special contracts” to healthcare professionals to compensate them working in the county hospitals. Nothing to do, he said, with what is happening in Spain, “with the physicians and nursing staff of ill-paid”.
“Who wants to raise their children without pediatric emergencies?”
Mayors, opposition and trade unions reject the closure of the birthing of Verín. Also the four schools of nursing of Galicia, which warn that in the trips of between 45 minutes and an hour and a quarter you will have to make the pregnant women of this region of galicia to give birth in Ourense (spain) “problems may arise, not provided for”. “That the manager of the Health Area of Ourense is claiming that due to the lack of deliveries, the professionals of these units end up losing expertise in the procedures putting at risk the lives of the baby and the mother with that lack of experience seems to us to be insulting”, point to these entities.
“The greater part of the Spanish hospitals who are not in big cities has a low level of births. Are perhaps these women at risk?”, ask Elena Gil, spokesman of the association, The Labor is Ours, that brings together users and professionals across Spain in favour of improvements in care during pregnancy, childbirth and postpartum. Gil believes that the Government “disguised as technical criteria” a political decision “makes no sense, unless there is a plan to dismantle all of the county hospitals”. Criticizes the “loss of rights” and the risk it poses to women and their children to the closure of the birthing of Verín: “The Government says it wants to repopulate the rural, but this did not help. What woman wants to raise children in an environment without pediatric emergencies?”.
