Ellen Allen: Tip of the iceberg for a maternal health crisis (Opinion)

Originally published November 12, 2025 in the Charleston-Gazette Mail.

The alarm bells should be deafening. When Greenbrier Valley Medical Center in rural West Virginia announced it will no longer offer labor and delivery services after April 2026, we must understand this is not a standalone decision but a symptom of a deepening crisis for mothers and babies in West Virginia.

Greenbrier Valley’s decision comes as part of a “reclassification” to become a Critical Access Hospital, a shift the hospital says is necessary under federal policy changes tied to Capito Care — the “Big, Beautiful Bill” — that cuts Medicaid funding by $1.1 trillion.

On paper, it’s about financial survival in a rural setting. But behind the spreadsheets and acronyms are real people — women who will now have to travel one or two hours, often on winding mountain roads, to give birth. What gets sacrificed in the name of financial stability is local access to safe childbirth.

West Virginia was already starting from a fragile place. According to the March of Dimes, our state’s infant mortality rate stands at 7.3 deaths per 1,000 births, among the worst in the nation. The maternal mortality rate — around 23.9 deaths per 100,000 live births — tells a similar story. Too many families already experience the heartbreak of losing a child before their first birthday or a mother during or after childbirth. And key indicators like preterm birth and inadequate prenatal care only compound the danger.

When a community loses the ability to deliver babies locally, the risks multiply.

Imagine being in labor and realizing you must drive over an hour through snow or rain, praying you
make it in time. Obstetric emergencies do not wait for clear skies or good roads. For many women,
this means delivering in transit, far from the care they need.

For those who do make it, continuity of care is broken — prenatal appointments may happen locally, but delivery happens elsewhere, often among strangers. And for infants who are premature or medically fragile, that distance can be the difference between life and death.The closure at Greenbrier Valley should be a wakeup call to every corner of West Virginia.

Only 18 hospitals in the state now operate labor and delivery units, down from 26 just a decade ago. Rural
“maternity care deserts” are spreading, and each one pushes expectant mothers further from the care they deserve. The policy shifts driving these changes may have been designed to keep hospitals afloat, but they’re also eroding the foundation of maternal and infant health. What’s described as “reorganization” in bureaucratic terms is, for rural families, a loss of safety, dignity and trust.

We know what happens when maternity care disappears. Infant mortality climbs. More women die from preventable complications. Families face trauma that ripples through entire communities. And in a state already fighting uphill battles on poverty, access and health outcomes, every closure widens the gap between who can get care and who cannot. Greenbrier Valley acknowledged the struggle to recruit OB/GYN providers. The hospital had been trying for over two years without success. This is the story of rural America told through the lens of one West Virginia hospital, and it should break all our hearts.

But heartbreak isn’t enough. West Virginians deserve better than to see safe childbirth become a privilege rather than a guarantee. Our leaders — at every level — must treat this for what it is: a public health emergency. We need greater investment in rural health infrastructure, targeted support to keep labor and delivery units open, stronger incentives to attract and retain OB/GYN providers and expanded telehealth and birthing center options so no family is left behind. We need systems that prioritize lives, not just ledgers.

The closure at Greenbrier Valley Medical Center is more than a headline. It’s the tip of the iceberg, revealing just how close we are to a full-blown maternal health collapse. West Virginia already ranks near the bottom in the nation for maternal and infant outcomes. We cannot allow this trend to continue unchecked.

Because behind every statistic is a mother, a newborn and a family hoping for a safe beginning.

Ellen Allen is executive director of West Virginians for Affordable Health Care.