Regional perinatal care in crisis: A case study of an urban public hospital

Arden Handler*, Deborah Rosenberg, Mary Driscoll, Mardge Cohen, Eddie Swift, Patricia M Garcia, Judy Cohn

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Regionalized perinatal care is intended to guarantee pregnant women and neo-nates access to appropriate care regardless of ability to pay. Its effectiveness depends on the willingness of hospitals to transfer high-risk patients according to established protocols and affiliations. This study examines maternal transfers (n = 896) to Cook County Hospital (CCH), a public facility and a designated perinatal center in Chicago. In 1987 and 1988, the majority (68%) of maternal transfers to CCH came from out-of network hospitals, and 52% of these came directly from another perinatal center. The data indicate that 62% of the out-of-network transfers who delivered were medically high-risk. The study also documents the transfer of women in active labor, a violation of federal law. The term “perinatal dumping” is introduced to mean the transfer of high-risk pregnant women between hospitals for economic rather than medical reasons. Strategies for safeguarding the integrity of regionalized perinatal care are discussed.

Original languageEnglish (US)
Pages (from-to)184-198
Number of pages15
JournalJournal of Public Health Policy
Issue number2
StatePublished - Jun 1 1991

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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