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Congressman Dan Newhouse, who represents Washington's 4th District, visited Coulee Medical Center Aug. 29 to discuss issues with rural hospitals, particularly in relation to obstetrical services.

Newhouse, joined by staff member Liz Daniels, sat down to lunch from the Fusion Café with CMC staff at the hospital and watched a presentation by Beth Goetz, the obstetrical nurse manager at CMC.

Goetz presented statistics related to rural area infant mortality compared to urban, maternal mortality, and more, to which Newhouse listened attentively and asked questions.

The presentation highlighted the disproportionate rate of maternal mortality among native Americans in the state of Washington.

"It made me mad," said Dr. Andrew Castrodale, obstetrical medical director for CMC. "Why do I live in a first-world state with third-world numbers?"

The state of Washington in 2014-15 had a maternal mortality rate of 196 deaths per 100,000 live births among native Americans, compared to 78 per 100,000 for African Americans and 25 for white. CMC's numbers are much better than the state's, staff pointed out.

A video included in the presentation showed Miah Bearcub telling her story. The now-teenager was born two months early at CMC weighing only 1 pound, 15 ounces. Bearcub lived to tell her story and become a positive figure in her community, something that likely wouldn't have been possible had OB services not been available at CMC.

Other Eastern Washington hospitals, such as Odessa and Davenport, have dropped OB services. If CMC did not offer OB services, there would be a 200-mile diameter area in eastern Washington missing those services, which would require people to drive 100 miles to give birth or for prenatal care.

"The thing that bothers me as they go away a little bit by little bit," Castrodale said, "is they won't come back because it's too damn hard to build the infrastructure. And it's not even the building; it's finding the right people. 'Do I trust these people?' When it falls apart, it's not going to come back. It's not going to come back to Odessa or Davenport."

"That's my fear," Castrodale continued. "If I can't replace myself and it goes away here, there's going to be a big, black hole, and it won't ever come back."

Castrodale emphasized that there are doctors that want to practice OB, but that there needs to be infrastructure for that, and the practice is not a profitable one, but rather a service.

"I would like to cut through some of that money that's going through those power lines," said Chief Executive Officer Ramona Hicks, as she pointed out the window toward power lines. "All that power Seattle is paying for, I can't get any dollars for it; it's maddening."

Losing OB services has other implications for communities, such as a drop in attendance for the schools. People simply don't want to live somewhere that they don't have appropriate care for their babies, hospital staff asserted.

"You watch the towns start to die," said Goetz, who is from Odessa. "Young families, young couples don't want to be in a town where you have to drive two hours to go to a doctor."

"It kind of becomes a spiral," Newhouse commented.

"Kind of like a toilet," Castrodale added.

Another point made in the presentation was that having OB staff at a hospital benefits patients with other issues. For example, OB staff, familiar with anesthesia or having blood loss expertise, can aid in emergency room situations that require the same knowledge.

"It's a critical issue about keeping the ability to deliver babies here," Newhouse said after the presentation. "It provides a lot of other benefits that increase the level of care that they provide to everybody else. Not only is it important for those that are pregnant, families that are needing these services, but for the rest of the population as well. It's an indication of the quality and level of service that is possible by being able to provide that one service."

"We will put our grey matter to work and work together to see what we can come up with," Nehouse said about finding a solution to keeping OB services in rural areas. "If there is anything available, we will find it."

"In this case, a hospital has real issues and challenges providing the care that they do," Newhouse said later. "They're trying to serve the residents of central Washington and having a high-quality hospital in communities within a reasonable driving distance. That's something we all should care about."