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written by guo xuemei

another tertiary hospital has closed its obstetrics department. on august 20, suzhou municipal hospital issued an announcement, deciding to officially stop the obstetrics outpatient, emergency, ward admission and obstetric card service in the baita campus from now on.

an insider told the medical world that as the number of births decreased, the business volume of the obstetrics department in the baita campus was affected. "sometimes there were no pregnant women (checked in) for a whole day, resulting in a waste of obstetric medical resources."

in order to change the current situation of the hospital's obstetrics department, suzhou municipal hospital merged the obstetrics department and obstetric medical staff that had stopped operating into the suzhou maternal and child health hospital (suzhou municipal hospital maternal and child health campus) which is about to be put into use, and put forward the goal of "striving to become a first-class domestic maternal and child health medical institution."

at a time when obstetrics departments are facing the risk of closure, the approach of suzhou municipal hospital has attracted considerable attention in the industry. integrating obstetric resources is also becoming a new idea for more hospitals to develop obstetrics departments.

the closure of obstetrics departments has affected tertiary hospitals

public information shows that the baita campus of suzhou municipal hospital is affiliated to suzhou municipal hospital (group), which consists of suzhou municipal hospital, suzhou maternal and child health hospital and suzhou rehabilitation hospital. it currently has six campuses, 3,200 open beds and more than 5,400 employees.

suzhou municipal hospital was formerly the suzhou second people's hospital. in october 2002, the municipal maternal and child health hospital, the municipal maternal and child health institute and the second hospital merged to form the suzhou mother and child medical care center. in 2005, the hospital merged with the third and fourth municipal hospitals to form the suzhou municipal hospital. therefore, the obstetrics department of the hospital has a long-term development accumulation. it is a key specialty in jiangsu province, and is also the suzhou critical and severe pregnant and parturient women rescue center and the jiangsu critical and severe pregnant and parturient women rescue guidance center, which is positioned as a critical and severe pregnant and parturient women rescue center.

according to data released by suzhou municipal hospital in 2017, the obstetrics department of this hospital has an annual delivery volume of about 20,000, and has admitted more than 40,000 high-risk pregnant women in the past five years.

with the relaxation of the two-child policy and the change in the structure of the fertility population, maternal and infant health care has become one of the focuses of obstetrics work, especially the treatment of critically ill pregnant women. in 2017, the obstetrics department of the hospital introduced the critical care medicine team of zhongda hospital affiliated to southeast university, striving to expand and strengthen the field of obstetric critical care.

although the obstetrics department of suzhou municipal hospital has a good reputation and influence, the operation of obstetrics departments in other branches is not optimistic. according to an insider, the obstetrics department of baita branch could only admit two or three pregnant women a week. the closure is to concentrate and optimize the medical resources of the group. the obstetric medical staff after the closure will also be arranged to the newly opened maternal and child health care hospital.

the closure of the obstetrics department at the baita campus has again aroused the industry's attention to the development difficulties of obstetrics. "medical world" found that this is not the first tertiary hospital to close its obstetrics department. the fifth people's hospital of ganzhou city, jiangxi province, announced earlier this year that it would stop obstetric services from march 11, 2024.

since the beginning of this year, guangzhou university of chinese medicine jinshazhou hospital, zhejiang jiangshan city traditional chinese medicine hospital and other hospitals have announced the closure of obstetric services. earlier, there were reports that hospitals in jiaxing, zhejiang, guangzhou, guangdong, laibin, guangxi, and xinyi, jiangsu would close their obstetric departments in 2023.

the data also confirms this trend. according to the china health statistics yearbook, the number of obstetrics and gynecology hospitals nationwide declined twice in 2020 and 2021, and by 2021 it had fallen below 800.

a report in "the paper" in april stated that before the wave of obstetric closures in cities, the first wave of obstetrics decline had already occurred at the grassroots level in townships. data showed that between 2017 and 2021, the number of outpatient and emergency visits to obstetrics and gynecology departments in township health centers decreased by about 15 million.

professor duan tao of shanghai first maternity and infant health care hospital said in an interview with china newsweek that the impact of declining birth rates on obstetrics will be significantly greater for public secondary and lower hospitals than for tertiary hospitals. however, the closure of the obstetrics department at suzhou municipal hospital baita campus shows that all hospitals, from township health centers to tertiary public hospitals, are likely to be closed.

this year, the closure of obstetrics departments has also attracted the attention of management departments. in march, the national health commission issued a "notice on strengthening the management of midwifery services", requiring public medical institutions to seek extensive opinions and protect the rights and interests of the public before closing obstetrics departments, and not to close obstetrics departments at will.

the document also points out that maternal and child health care institutions at all levels, public general hospitals at or above the second level, public medical institutions that undertake the tasks of critically ill pregnant and postpartum women rescue centers, and public primary medical and health institutions in sparsely populated areas should, in principle, ensure continuous obstetric services, and emphasize that public medical institutions must assume the ultimate responsibility for obstetric services.

obstetric medical services are "rolling up"

on the same day that the obstetrics department of suzhou municipal hospital baita campus was closed, suzhou maternal and child health hospital announced that it would officially open on august 30.

it is reported that the construction of suzhou maternal and child health hospital is benchmarked against modern tertiary maternal and child health hospitals, and is positioned to meet the personalized medical and health care service needs covering the entire life cycle of women and children. the hospital has 800 approved beds and will open multiple departments including gynecology, obstetrics, neonatology, ultrasound, reproductive genetics center, pediatrics, child health, maternal health, and dermatology.

faced with the challenge of declining obstetric business volume, the suzhou maternal and child health hospital, which is about to be put into use, has shown many highlights in planning and construction, and has put forward the goal of "striving to become a first-class maternal and child health medical institution in china."

to this end, the maternal and child health hospital attaches great importance to humanized design. the hospital implements zoning and hierarchical management, and the functions of each area are clearly defined, which can effectively avoid patients' blind running around and repeated trips. the outpatient, medical technology, inpatient and other buildings of the hospital are all designed with full corridors, which is convenient for patients and their families to go to any area without being exposed to the sun and rain.

in terms of obstetrics construction, the maternal and child health hospital has planned and built the largest digital family delivery room (ldrp) group in the country, with a total of 54 family delivery rooms, 20 of which are full suites, integrating functions such as pre-delivery preparation, delivery, and postpartum recovery, providing full-course diagnosis, treatment and nursing services for pregnant women and newborns.

at the same time, the hospital has also introduced internationally advanced four-dimensional maternal and child ultrasound, fetal heart ultrasound and other diagnostic and treatment equipment, which is expected to improve the level of medical treatment, especially the rescue capabilities of critically ill pregnant women.

in addition to clinical capabilities, the suzhou maternal and child health hospital, which is about to be put into use, also pays great attention to humanistic care, with special neonatal family wards and postpartum rehabilitation centers.

according to the hospital, the neonatal family ward will accompany mothers and babies with a nursing model full of humanistic care and medical warmth, and the postpartum rehabilitation center will provide comprehensive and professional services and facilities to ensure that mothers and newborns receive the best care for their recovery and growth after delivery.

by building comfortable medical care and integrating obstetric resources, the competitiveness of suzhou maternal and child health hospital's obstetrics department will be improved. according to people familiar with the matter, after the opening of suzhou maternal and child health hospital, the number of obstetric patients will increase significantly compared with the baita campus.

similar to the practice of suzhou municipal hospital, many other hospitals in china have also begun to optimize and integrate obstetric resources in recent years. in september 2023, the yinzhou district health and health bureau issued a notice stating that in order to optimize and integrate maternal and child medical resources, the obstetrics department of yinzhou district second hospital will be integrated into the newly built and put into use women and children's medical center of ningbo university affiliated people's hospital.

in january this year, the gynecology, obstetrics, pediatrics, child health and vaccination departments of the three hospitals in the xinzheng campus of yilong county people's hospital, county traditional chinese medicine hospital and county maternal and child health hospital in sichuan province announced an optimization and integration. after the integration, all medical services of the obstetrics and gynecology and pediatrics departments of the three hospitals were transferred to the xinzheng campus of the county maternal and child health hospital.

facing a decline in the number of births, hospitals' obstetric medical services have been "rolled up". zhou shuyin, chief physician of the department of obstetrics and gynecology at the third people's hospital of ouhai district, wenzhou city, told "chao news" that they take extended services as the starting point, from prenatal care to postpartum rehabilitation, to lengthen the perinatal service chain and provide patients with "one-stop" maternal and child health services.

in a speech at the end of last year, duan tao, a well-known obstetrician and gynecologist, said that today's obstetric services need to transform from a single obstetric business to a full life cycle medical service for women, children and infants. "in the traditional obstetric service model, giving birth is more like a 'one-time transaction', and the mother only needs you when she is about to give birth. but in fact, the trust established through obstetric services is very valuable."

chai yun, director of the obstetrics department at hangzhou obstetrics and gynecology hospital, also said in an interview with the media that the "main contradiction" of obstetrics has changed. in her opinion, in the past few decades, public hospitals mainly solved whether pregnant women could be admitted to the hospital to give birth, but now it has changed to how to make them give birth more comfortably.

in june this year, the national healthcare security administration issued the "guidelines for the establishment of obstetric medical service pricing projects (trial)", which established separate projects such as "labor analgesia", "doula delivery" and "family companionship", supporting medical institutions to provide humane delivery services centered on mothers and improve the comfort of mothers during delivery.

in the context of declining birth rates, focusing on improving medical service capabilities and getting closer to the service quality level of private hospitals has become a new direction for the development of obstetrics in public hospitals.