It’s a maternity care desert in rural Pennsylvania, but there are reasons to hope that may change in the future.

Dr. Kyle C. Kopko, executive director of the Center for Rural Pennsylvania, spoke with The Era Wednesday about the maternal care desert and the possibility of state agencies taking some action in the future.

In February, the issue that had been of rising concern over the past few years came to the public’s attention in a big way when UPMC Cole in Coudersport announced it would move labor and delivery services to Wellsboro. Penn Highlands Elk’s maternity care services were moved to DuBois in 2024, and Bradford Regional Medical Center’s were moved to Olean, N.Y., in 2019. That left a swath of counties throughout northcentral Pennsylvania bereft of child-birthing services.

The center held a hearing in February, and heard some powerful testimony from Kane Mayor Brandy Schimp.

“It was her testimony that prompted us to do a fact sheet,” Kopko said.

She had identified the maternity care desert as a major issue facing the region.

“Without these services, attracting women and families to rural PA is even more difficult and as a result, our population will continue to decrease,” she said. She had her children at BRMC, which has since closed.

She testified, “Recently, a friend of mine within the last month drove an hour and 45 minutes to deliver her baby, delivered it within 15 minutes of walking in the emergency room doors. So we are at a crisis point as far as labor and delivery.”

Upon hearing that, Kopko said, the center realized there had been no analysis done on the depth of the problem. “What’s happening in the northwest is a big concern.”

However, they’ve since learned it isn’t limited to just this region — “it’s a phenomenon happening in many corners of Pennsylvania.”

In fact, the center found that 22 of the 67 counties in the state do not have a hospital that provides labor and delivery services. All 22 are in rural areas. Kopko was careful to note that most counties have prenatal and postnatal care, but are lacking in a facility equipped for labor and delivery.

“Maternity services in general might still be lacking, there’s not the same level of access,” he said. “It’s important for stakeholders to keep in mind just because there is an (obstetrician) they aren’t able to do everything.”

The center’s fact sheet indicated that residents of counties without labor and delivery services must travel an average of 27 miles (linear on a flat map) from the county seat to the nearest hospital providing these services.

A table in the fact sheet gives that information for rural counties. For example, from Smethport, again linear on a flat map, the distance to Olean General Hospital in New York is 27 miles. From Emporium to Penn Highlands DuBois is 52 miles with the same type of measurement.

“But there’s mountains and weather,” Kopko said with a laugh, “and animals. They don’t call it Elk County for nothing.”

The center’s fact sheet reads as follows: “The closure of labor and delivery units also strains local healthcare systems, particularly emergency services, and impacts the availability of prenatal and postnatal care. These closures may further affect the overall public health of rural communities. Additionally, the lack of labor and delivery services may exacerbate population decline in rural communities.”

Addressing transportation concerns, hospital officials have said there are ambulances for residents to rely on. However, in rural Pennsylvania, there aren’t many full-time ambulance services. And the ones that are in business find themselves busy on multiple calls, taking patients all over the region for treatment.

How did rural Pennsylvania get here? Kopko said many factors have played into it.

“The inability to get the workforce into rural areas in the first place,” he said, listing one. Others include costs for malpractice insurance and reimbursements for Medicare and Medicaid. “It’s a confluence of many different factors.”

The message that rural Pennsylvania needs help is being heard.

“I know the governor’s office is acutely aware of this,” Kopko said.

And the departments of health and of human services have been involved in initial discussions.

“From what we’ve gathered from listening sessions, they are looking at anything from standalone birth centers being an option, to any opportunities for nurse midwives being certified,” he said.

“We’re trying to provide as much information as possible to state agencies who can” help.

“If this isn’t addressed it’s going to exacerbate population decline, workforce decline — It’s going to spiral,” Kopko said.

An event was held in Philadelphia earlier in the week, he said. “One of the things that came up was the reestablishment of labor and delivery services in Uniontown. That was at least heralded as regaining a service.

“I think it is possible with the right stakeholders and the right intervention where we might see some of these (services) coming back in the future,” he added. “That does give some hope and some sense of optimism.

“There are some assets on the ground, there are some opportunities,” Kopko said.

While labor and delivery services are at a critical stage, women’s health issues in rural Pennsylvania is another area of concern. “That’s part of the issue we’re trying to conceptualize.”

Kopko said the center is also looking at what will happen when Rite Aid closes stores in rural Pennsylvania. That study is expected to come out soon.