Taking the Highway to Have a Baby

By Leslie Berestein

It wasn't morning sickness that made Vanessa Valdez's first trimester of pregnancy so hard--it was homesickness. So when the check-cashing company she worked for in Tucson, Ariz., offered her a transfer to her hometown of Douglas, she jumped at the chance. Four months pregnant at the time, Valdez, 24, was delighted to come home to her boyfriend, her parents and the 2-year-old son she left in their care when her job took her out of town. But now, as she prepares to give birth to a baby girl, she is dealing with a major drawback: there is no obstetrician within an hour's drive to deliver her child.

Valdez gave birth to her first child at Copper Queen Community Hospital in Bisbee, an old mining town just 26 miles northwest of Douglas. But when six family practitioners decided they couldn't afford the soaring malpractice premiums required for them to keep delivering babies, the hospital was forced to close its delivery room. Suddenly rural Cochise County, a 6,000-sq.-mi. expanse of mountains and desert along the Mexican border, had but one delivery room left for its 118,000 residents. It is in Sierra Vista, 50 miles northwest of Valdez's home. Which means that a week before her Aug. 4 due date, Valdez will pack her bags and camp out at the home of family friends near the hospital. "It sucks. It's not the same as being in your house, with your friends and your family," says Valdez, a petite woman who is otherwise quick to laugh.

As rising malpractice-insurance costs force a growing number of physicians to change states, drop certain procedures and even quit medicine, many patients like Valdez are finding themselves abandoned. In Las Vegas, where a number of obstetricians have stopped accepting patients, forcing some women to drive to Utah for prenatal care, a pregnant radio host took to the airwaves and begged her listeners to help her find an obgyn. (Her unorthodox method worked.) In Pennsylvania, a particularly unlucky senior has lost his neurosurgeon and orthopedic surgeon to other states, and now his rheumatologist and urologist are threatening to move as well.

Valdez doesn't have it quite so bad--but don't try to tell her that. While she is busy looking for a new doctor in Sierra Vista for the big day in August, she is still commuting two hours to keep appointments with her current doctor in Tucson. The road to Sierra Vista winds through mountains and creosote flats. "It's going to be summer now, and it's getting hotter here," she says. "I'm afraid of the car breaking down again"--as it did recently while Valdez was driving alone on her way home from Tucson.

Some expectant couples rent motel rooms in Sierra Vista for when their babies are due. But some who can't afford a room or whose timing is off end up with the baby arriving in the middle of the night while they're racing along the highway, according to Copper Queen Hospital CEO James Dickson. The intersection of Highways 80 and 90 is listed as the place of birth on the certificate of a baby girl born in the front passenger seat of a car where those highways cross. Women lacking transportation, a common problem in this working-poor area, have given birth in ambulances. Others may be giving birth across the border in Mexico or at home, says Dr. Jennifer Ryan, CEO of the Elfrida-based Chiricahua Community Health Centers.

Health-care administrators in Cochise County plan to open a birthing center in Bisbee, which would be run by the federally qualified Chiricahua clinic and would be able to shelter doctors from high malpractice-insurance premiums. If all goes well, the center will open next spring. But for Valdez and many other new mothers, that will be too late. Valdez doesn't know whom to blame--doctors, lawyers or insurance companies. She just knows that come late July, she will have to spend the final, awkward week of her pregnancy waddling around as a houseguest. That's enough to make anyone feel homesick. --By Leslie Berestein