Almost a third of maternity hospitals are at stake. Reason? Few births, few experiences

For some maternity hospitals, the future is still very uncertain. Hospitals are negotiating new contracts this year, and the future of the department where babies are born is now being intensively discussed.

In contrast to other parts of hospitals, there is a professionally determined limit in the field of obstetrics, which is also easily comparable. The Czech Gynecological and Obstetrical Society stipulates that in order to maintain the erudition of the staff and ensure the safety of mothers and newborns, it is necessary to perform at least 600 births per year.

This number is also mentioned in the negotiations by the General Health Insurance Company (VZP).

“The position of the Czech Gynecological and Obstetrical Society ČLS JEP confirms the fact that, from the point of view of the safety of care for the mother and the child, it is certainly more appropriate when the birth takes place in a facility where there are experienced personnel who perform births regularly, even several times a day, and it is therefore better prepared, for example, for possible complications,” says VZP spokesperson Viktorie Plívová.

But this does not mean that every maternity hospital will end up below this limit. Regional availability is absolutely essential. If, for example, the maternity hospital in Jeseník were to close, the nearest would be 50 kilometers to Šumperk or 60 kilometers to Krnov.

“In the case of Jeseník, it should be taken into account that it is the only medical facility with acute inpatient care in the region with a catchment area of ​​almost 40,000 inhabitants,” says Jana Chrastinová, chairwoman of the hospital’s board of directors.

If all maternity hospitals with fewer than 600 births per year were to close, 29 percent of them would have to close. However, localities where such a reduction is possible will be addressed during the negotiations.

“Therefore, if there are three maternity wards operating in one region, each of which performs 200 births a year, then it really makes sense, especially from the point of view of ensuring quality care and a certain routine even for more complicated births, to concentrate this care in, say, only two wards and with a third provider to agree on another type of care, where personnel and technical capacities can be used,” adds the VZP spokesperson.

Where were the least born

For example, from Chomutov to Kadana and Most it takes 20 minutes both ways, and there is a maternity hospital in every town. However, the latest data from the Institute of Health Information and Statistics (ÚZIS) for 2022 show that there were “only” 550 births in Chomutov.

At the same time, it is also necessary to consider the demographic development. It has been very unfavorable in recent years and it cannot be expected to improve rapidly in the future either. On the contrary, it looks worse than even the pessimistic predictions of the Czech Statistical Office estimated. We covered the decline in the birth rate here.

And it shows even in the little things. Most children in Prague are born in Podolí in Prague, but from March mothers do not have to register there anymore. In the past, however, it was necessary.

“The primary reason for canceling the registration was to simplify the administrative system. The secondary reason was indeed the decrease in the number of births,” explains Gabriela Hošková, spokeswoman for the Maternal and Child Care Institute in Podolí.

While in Prague the debate is more about minor changes in traffic due to the falling birth rate, in the regions it can be an existential question. It is such a very sensitive subject that invites criticism.

“Comparing hospitals and maternity hospitals of different sizes based only on the absolute number of births is misleading, the number of births per gynecologist is far more telling. During the negotiations with the VZP, all these views are discussed, not just the proclaimed 600 births,” explains the director of the Prachatice hospital and also the chairman of the Association of Czech and Moravian Hospitals, Michal Čarvaš.

It was in Prachatice that, according to the latest data from the ÚZIS, the fewest births took place from the year before last – 185. However, according to Čarvaš, this can be an advantage for mothers.

“In a small hospital with fewer births like ours, we try to offer women in labor a personal approach, a family environment and treatment,” adds Čarvaš.

However, due to the general shortage of doctors, a number of maternity hospitals have had to close themselves in recent years. The last time it happened last year was in Stodská hospital. However, maternity hospitals are only the beginning of the future transformation of hospitals that is about to take place. In general, there will be fewer acute beds and, conversely, more places for follow-up and long-term care.