In the October 27, 2021 Executive Council meeting, Councilor Cinde Warmington shared the importance of continuing to invest in New Hampshire’s maternal fetal health care outcomes-- and the dangers of the newly-enacted abortion ban, which criminalizes doctors, for recruiting and retaining providers to the state.
The following exchange begins at 44:59.
Councilor Warmington: So, at the last meeting, I asked that the Governor bring back the Family Planning contracts at every meeting until they were approved by the Council, and I just first make a note that they are not on today’s agenda.
I would like to talk about the public health issues related to family planning. I had the pleasure of speaking with Dr. Barry Smith earlier this week. He’s an (retired) obstetrician at Dartmouth-Hitchcock Hospital, and I learned some very interesting things about maternal fetal health in New Hampshire. He stated that the United States does not rank all that well in the world when it comes to maternal fetal health, but that New Hampshire, in fact, ranks very high. And by organizations that grade maternal fetal health, New Hampshire is one of only four states in the union to get a B+, and no states rank higher than that. It’s not easy for a rural state to achieve that.
But he also said that our system is fragile. It’s critically dependent on being able to recruit and retain physicians who subspecialize in maternal fetal health, and if you can’t recruit maternal fetal health specialists, the general obstetricians won’t have a place to refer complicated pregnancies and won’t feel safe practicing in our state.
He noted that we currently have only 4.5 FTE (full-time equivalent) maternal fetal physicians practicing in our state, some are approaching retirement. He also noted that the newly-enacted 24-week abortion ban, which criminalizes physician conduct is a “clear and present danger to the provision of obstetrical care in our state.” He said that speaking with the physicians at Dartmouth-Hitchcock, they believe the specialty physicians will be afraid to come to our state, and if they don’t come, the general obstetricians won’t come, either.
We’ve already had ten maternity programs close in our state in recent years. We have maternity deserts in our state, where women drive hours to receive maternity care.
Do you agree that we need to do everything we can to protect our fragile maternal fetal health care system?
Commissioner Shibinette: Yes. I think that it makes sense that specialty and subspeciality providers would typically settle in states that are more supportive and less restrictive around family planning and abortion. The more restrictive we become, the less attractive New Hampshire becomes for those specialties. And you are correct that there are very big gaps in our state when it comes to maternal and child health around in-patient obstetrics, things like that, and I do think that this has the potential to make that worse. What you are going to see from DHHS in the future, probably in calendar year 2022, is proposals to try to financially incentivize different health systems to continue to provide comprehensive labor delivery service in certain parts of the state, where you’re exactly right – women have to drive hours to receive women’s health.
Councilor Warmington: Do you believe that this is an important public health matter?
Commissioner Shibinette: Yes.
Councilor Warmington: And that criminalizing doctors presents a threat to the system and a threat to women and children in our state?
Commissioner Shibinette: Yes.
Councilor Warmington: Thank you.
Thanks to New Hampshire’s long standing bipartisan commitment to smart public health services and investments, the Granite State has enjoyed the top ranks for maternal health outcomes. It’s clear from public health experts that this is at risk with the newly enacted abortion ban, which criminalizes doctors for doing their job and helping their patients and their families during complex situations.