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The Impact of Maternity Ward Closures on Maternal and Neonatal Health

picture of ultrasound of pregnant woman
Evidence from Maternity Ward Closures Photo: Kennet Ruona

Healthcare consolidation is a global trend aimed at increasing efficiency in the face of rising costs and declining rural populations.

A recent study examines the effects of maternity ward closures in Sweden from 1990 to 2004 on maternal and neonatal health, as well as the associated birth technology choices and travel distances to wards. The research reveals a complex set of outcomes.

“Maternal trauma and prolonged labor rates increased due to ward overcrowding, while fetal stress and infant trauma decreased as births shifted to higher-quality, larger wards”, says Petter Lundborg, one of the authors. 

“Importantly, increased travel distances to wards had no significant negative impact on maternal outcomes. The findings highlight the nuanced effects of healthcare consolidation, suggesting that while efficiency and quality improvements are possible, they must be managed carefully to avoid adverse effects on maternal health.”

The study, done by Daniel Avdic, Petter Lundborg and Johan Vikström, show how closures of maternity wards affect maternal and neonatal health. Using data on all hospital births in Sweden between 1990 and 2004, they have compare changes in birth-related outcomes across hospital catchment areas that were differently exposed to ward closures. The findings show that the closures increased maternal obstetric trauma, but also decreased fetal stress and infant trauma among newborns. Adverse maternal outcomes are mainly driven by ward overcrowding, whereas increases in travel distance have no distinguishable effects. Positive effects on infant health reflect a shift of births from smaller to larger wards of higher quality.

Does Health Care Consolidation Harm Patients? Evidence from Maternity Ward Closures (paper in AMERICAN ECONOMIC JOURNAL: ECONOMIC POLICYVOL. 16, NO. 1, February 2024