The Emergency Medical Treatment & Labor Act (EMTALA) requires hospitals to provide birthing services to women in active labor. The law considers this a medical emergency and hospitals that deny services or deliberately deliver substandard care are committing a serious violation. It is a common, and growing problem as an increasing number of hospitals are turning away patients in desperate need of emergency medical service. When this happens, they violate their duty of care to patients and can face significant civil liability for their refusal of service.
EMTALA requires hospitals to provide triage care to pregnant women who arrive in the emergency room while in active labor. This includes providing a proper screening to determine the health of both the mother and fetus. Emergency room personnel are required to stabilize the patient, and if necessary, transfer her to a facility that can provide delivery care. Hospitals are not allowed to transfer patients who are at critical stages of the delivery process. When transfer is required, it must be performed by an ambulance or qualified service. Even so, many hospitals turn patients way and require them to drive themselves to the hospital to which they are being referred. Finally, EMTALA prohibits denial of service based on the individual's ability to pay or insurance status.
Rural Hospitals are Common Violators
Many rural hospitals do not offer obstetric care. Between 1985 and 2002, the number of hospitals in rural areas that did not have obstetric units rose from 24% to 44%. As of 2017, more than 760 hospitals in the United States have eliminated obstetric care. However, this does not mean they cannot provide delivery services because all board-certified emergency room physicians receive training on how to deliver babies during their residency period.
The lack of a specialized care facility does not absolve hospitals of their legal duty to care for pregnant women who arrive in active labor. EMTALA requires these hospitals to provide care until the placenta is delivered or until after the baby is born. Over the past five years, 20 hospitals in rural areas have been cited for EMTALA violations. Failure to provide prompt and thorough treatment can result in potentially life-threatening consequences for both mother and child. Hospitals know their duty and legal responsibility, yet many continue to shirk their responsibilities and legal duty to mothers and children in need or emergency medical services.