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The Harlan City Council talked about Harlan ARH Hospital’s recent decision to eliminate labor and delivery services during the panel’s regular February meeting.

Harlan City Mayor Joe Meadors brought the subject up early in the meeting.

“We got a letter today from (Judge-Executive Dan Mosley) about ARH closing the OBGYN portion of the hospital,” Meadors said. “He doesn’t ask for a motion or resolution or anything…I don’t know what we can do. There’s very little we can do. I’m in favor of passing a resolution to try to persuade ARH to take another look at this.”

According to Meadors, Harlan ARH Hospital is unlikely to reverse the decision.

“The judge (Mosley) has made several key points,” Meadors told the council. “One is the high rate of high-risk pregnancies in Harlan County. The other is the transportation issues getting to and from Whitesburg or Middlesboro.”

He pointed out the trip to Whitesburg or Middlesboro may be difficult or impossible in the winter due to the weather.

“If you have somebody in active labor, they may not make it to Middlesboro or Whitesburg before they deliver,” Meadors said.

He mentioned additional points Mosley made in his letter.

“Another point is the adverse impact on pediatric services. Another is the deterrent to the future growth of Harlan County. Then he also makes mention of the staffing issues the ambulance service has encountered here in Harlan County,” Meadors told the council.

Meadors asked the council for their assessments of the situation.

“I think one thing that people need to understand is the majority of the pregnant women in Harlan County have been having their babies out of Harlan County,” said council member Ann Hensley. “The hospital has been averaging two deliveries a month for over a year, and it’s been declining for several years.”

The downturn may also be partially attributed to the population decrease Harlan County has experienced for several years, Hensley noted. She also pointed out other medical facilities have seen a downturn in OBGYN staff.

“MCHC had an OBGYN out here full time and she was very active,” Hensley said. “But she’s been gone for going on two years now. When she left, that really affected the number of deliveries they were doing at the hospital.”

Hensley added fewer pregnant women using a facility will result in staffing issues.

“Your staff loses their skills,” Hensley said. “That’s something that’s highly technical, they need the daily activity of providing those services to those women and babies.”

Hensley said Harlan ARH has been sending their nurses to Whitesburg ARH to keep their delivery and labor skills sharp.

“It still isn’t like you’re doing it every day,” Hensley said. “People just aren’t using Harlan (ARH).”

Hensley also mentioned if people do not use a service, it is hard to recruit people to provide the service.

“If you can’t recruit the doctors, and your local population doesn’t use your local business, whatever it is – if I open up a grocery store and have two customers come in per month, I’m going to have to close down,” Hensley said. “It is a loss to the county, and I don’t disagree with any of the things Dan (Mosley) said in his letter, but the point is if you have a service available and you don’t use it, you are going to lose it. I don’t think ARH is going to change their mind about this.”

Meadors voiced his agreement with Hensley.

“Ann, I think you’re right on a lot of issues there,” Meadors said. “I know a lot of people have chosen to have their babies in Corbin, Middlesboro, Knoxville, or wherever. So, my only argument to ARH is we need to recruit the dickens out of getting a good OBGYN. We need somebody here.”

Hensley mentioned it is difficult to recruit an OBGYN to a hospital that does not have enough deliveries happening.

“If they interview an OBGYN, they’re going to want to know how many deliveries you had last year,” Hensley said. “If they see you only had 24 or 25 for a whole year, they aren’t going to be interested…it is definitely a dilemma, and it is a sad thing for Harlan County to lose that service. But you have to have business in order to provide the service.”

After some further discussion, the council took no action on the matter.