The deserted maternity ward in Manacor: mothers referred, midwives laid off, and the Health Plan under scrutiny
The government has left the facilities only for emergencies, citing a lack of gynecologists, and the controversy has led them to announce the reopening.
PalmAn empty delivery room, mothers avoiding Manacor Hospital for fear of not receiving care, a tense work environment, and widespread frustration among midwives and gynecologists. This is the reality the hospital has faced since January 19, when the Valencian Health Department activated a contingency plan due to a shortage of gynecologists to cover shifts after 3:00 PM and on weekends, following unexpected absences. The plan has cleared the delivery room: some mothers have been transferred to other hospitals, and others have opted for alternative facilities. The Health Department plans to suspend the measure and restore normal services the week of January 26. It remains to be seen whether it will have to be reactivated later. For now, the Health Department has experienced firsthand the outrage of patients and staff after a week in which the Manacor delivery room has been deserted and the midwives, with nothing to do, have mobilized.
"The staff at the Manacor maternity ward need help. They haven't been attending to any births for days. The midwives are doing nothing. The situation is unsustainable and there's a bad atmosphere." This is how an authorized source at Manacor Hospital summarizes the situation at the center since the Ministry of Health activated the plan. Currently, there is only one doctor on call, compared to the usual two. According to sources at the hospital, only six of the attending physicians (less than half) are covering shifts. They are voluntary, and both those over 55 and pregnant women have the right not to do them.
Midwives assert that they can attend to normal deliveries, which constitute the majority. Ironically, these are the cases the plan diverts. Now, in Manacor, only imminent births, life-threatening emergencies, and other urgent situations are being attended to. "The majority of births in the Balearic Islands are normal, and it is the midwives who guarantee their safety, support, and respect," explains the Balearic Association of Midwives. The organization believes that "forcing" women to travel to other hospitals at such a critical time increases "unnecessary" risks and can create situations of healthcare insecurity, especially in emergencies.
"We are calling on all gynecologists in Mallorca, the other islands, and the mainland to come and do on-call shifts, because the situation is unsustainable. There are professionals who are crying all day long," another professional from the Manacor center laments. In a normal month, the main hospital for the Levante region handles an average of three births per day. During the contingency plan in December, only two births were attended to in the 15 days it lasted. Since January 19 (and up to the time of writing this article), no births have been attended to.
During the week, the Balearic Islands Health Service (IB-Salut) has desperately searched for gynecologists through job portals and all available means. Meanwhile, the other hospitals have suffered from the overload of care. At Son Llàtzer Hospital, the healthcare workers consulted reported feeling more pressure, between attending to their assigned births and those that should be handled by Manacor Hospital.
Rights violated
The Naixença association advocates for physiological and respectful childbirth and rejects the plan. It believes the plan eliminates an essential service and violates fundamental rights, creating a serious lack of equity, because women in the same region receive different and detrimental care. The organization questions the criteria used by management and the Catalan Ministry of Health and considers it unjustifiable that the absence of some gynecologists serves as an excuse for such a drastic decision, especially when the midwifery staff has not been reduced and midwives are responsible for attending the majority of births. Naixença also believes that any contingency plan should prioritize the maternity ward of a hospital serving more than 130,000 people: "If it is necessary to redistribute the service, then do so, but never by reducing the full operation of the maternity ward." The association points out that, for ten years, the maternity ward at Manacor Hospital operated with one gynecologist and one midwife, handling over 1,200 births annually, while now, with around 900 births per year, "the transfer of women cannot be justified." The reality for gynecologists in Manacor is worse than that of their colleagues in other hospitals. According to hospital sources, with the available staff, and if two are needed per shift, each gynecologist would have to cover between seven and eight shifts each month, many more than they would if they had a position at the island's two main hospitals: Son Espases and Son Llàtzer. The president of the Balearic Society of Gynecology and Obstetrics, Agustín Hernández, explains that 24-hour shifts "are very stressful." "I don't perform a cesarean section the same way in the first hour as I do in the 23rd," he says as an example. "Obviously, women have the right to a calm process and to give birth wherever they want. They are the top priority. But one gynecologist isn't enough. You should have two for any location, because a birth goes well until you stop going," she argues. She acknowledges that, if it's a low-risk pregnancy, midwives can perfectly well attend to it. "In Manacor, they're underutilized, but so are the gynecologists, who are having a hard time with the current situation," she adds. Meanwhile, the demand from mothers is growing stronger, and, according to professionals, few are going to the Manacor hospital anymore.
The midwives at the center are worried about the risk to a mother and her baby if they don't receive immediate care. Besides this, the impact of the contingency plan goes beyond gynecology. "Women in labor are being transferred to other hospitals by ambulance for non-emergency services. What would happen if someone had a heart attack, a real emergency, and there wasn't an ambulance nearby?" sources at the center wondered. Despite the contingency plan in place at the time of writing, the staff are urging pregnant women: if they are in labor or are afraid, they should always go to the nearest center, where they will be helped in every way possible.
