That St. Mary’s Sacred Heart Hospital’s labor and delivery unit in Lavonia, Georgia, is about to close is clear to anyone who walks its halls. A message on the unit’s break-room whiteboard tells employees they can take home the holiday decorations that were long used in the office. Other items, like a coffee maker and air fryer, are up for grabs too.
St. Mary’s Health Care System’s management told employees in September that it would consolidate its labor and delivery services in Athens, Georgia, which is nearly an hour from Lavonia. It cited the “changing demographics” in the region and difficulty recruiting physicians to Lavonia, a rural town located in northeast Georgia in a red district. The health care system said that “recent Congressional cuts to Medicaid solidified this decision.”
The labor and delivery unit is set to close on Monday, and would mark one of the most visible effects of the reconciliation bill that became law over the summer. Georgia mothers, lawmakers and medical experts in the region are warning that the closure would put the lives of pregnant mothers and infants at risk.
“It’s pretty shitty to get rid of a unit that was critical access for women who couldn’t afford to make it to the other hospitals,” a former nurse in the unit, who requested anonymity for fear of professional retribution, told NOTUS.
“A lot of these women are either going to have babies on the road because they can’t make it in time, or they’re gonna just go into labor and go into the ER here, and hope that the ER can deliver their baby,” the nurse continued. “Because a lot of people think that that’ll be the same, and it’s not.”
The reconciliation bill cuts more than $1.1 trillion in Medicaid, and an estimated 11.8 million people could be left uninsured by 2034, according to the Congressional Budget Office. Hospitals across the country — and particularly the South — are facing financial dilemmas as a result, from Lavonia to Claxton, Georgia, and across state lines to Louisiana, Mississippi and beyond.
St. Mary’s Sacred Heart Hospital’s labor and delivery unit provides the type of services that a coalition of policymakers and activists with wide-ranging beliefs are warning will be missed.
St. Mary’s Health Care System said in a statement, “We have no further comment,” and referred NOTUS to its previous release.
The hospital’s labor and delivery unit is the only delivery unit in a nearly hour radius for people who live in Lavonia, which is located in Franklin County, and the surrounding towns and cities. But it’s far from the only hospital now faced with tough choices about how to operate.
According to a report published in August from the Center for Healthcare Quality and Payment Reform, 42% of rural hospitals offer labor and delivery services. Fewer than 33% of rural hospitals in Louisiana, Mississippi, Alabama, Florida and Arkansas offer maternity care.
In addition, Kentucky and Louisiana are among the five states with the highest number of labor and delivery services at risk in rural hospitals, according to an analysis by the National Partnership for Women and Families.
“I would certainly say anecdotally, and I think the data, the stats show us, being able to access care across the state, across the Deep South is already really difficult,” Kaitlyn Joshua, a co-founder of Abortion in America based in Louisiana, told NOTUS. “A lot of us live in what’s called maternity-care deserts.”
In its initial release, St. Mary’s Health Care System said the Lavonia hospital’s emergency department was “trained, prepared and equipped” to handle emergencies that may arise during labor. It added that “the patient would be transferred by ambulance to the nearest appropriate facility” if additional services are needed.
However, this hasn’t put current hospital employees at ease.
A high-ranking official at St. Mary’s Sacred Heart Hospital, who would only speak to NOTUS on the condition of anonymity, said patients have been stressed about trying to find a physician in a nearby city. The official also expects pregnant women who are about to give birth to still visit the emergency room despite the labor unit’s closure.
“Obstetrics is a specialty,” the official said. “It is not the general thing that people in emergency rooms are fixed to deal with. As a rule, when a pregnant patient shows up in an emergency room at a facility that has a labor delivery, they are shuffled out of that emergency room as quickly as possible.”
“The ER physicians still feel ill-equipped, as do their staff, to handle any of the complications that arise from pregnancy and labor,” the official added.
Current and former staff told NOTUS that the hospital typically delivered more than 300 babies a year, and that the majority of the women who visited the unit relied on Medicaid for service.
“A lot of our mothers who were going to the gynecologist OB doctor there in Lavonia and planning to deliver there at St. Mary’s, they have just been very upset, very emotional about losing that care,” Tammy Frye, the executive director of the Hart Life Pregnancy Care Center, an anti-abortion organization, told NOTUS. “Now they’re having to find a doctor that’s going to be at least an hour away, or an hour 15 minutes away.”
“I feel like some mothers may opt out on the prenatal care that they’re gonna need because of transportation issues,” Frye continued.
Lavonia has a population of a little more than 2,000 residents, and it is represented by Rep. Mike Collins, a Republican who voted for the reconciliation package.
“St. Mary’s Sacred Heart Hospital made a business decision to close its labor and delivery unit due to personnel recruitment challenges and a lack of patients to support these services,” Collins’ office said in a statement to NOTUS. “Rep. Collins is invested in ensuring rural hospitals can provide the care their communities need, which is why he supported — while Jon Ossoff and Senate Democrats opposed — the One Big Beautiful bill and its $50 billion investment for states to support rural hospitals.”
The reconciliation bill allows rural hospitals across the country to request $50 billion — $10 billion a year — from 2026 to 2030. However, critics of the bill, like Democratic Sen. Jon Ossoff, have said that the money isn’t enough to offset the cuts.
Bo Hatchett, a Republican state senator, told NOTUS that while the decision to close the unit was “unfortunate,” he hoped the hospital could reopen the unit in the future.
“At the state Legislature in Georgia, we’re doing everything we can,” Hatchett told NOTUS when asked if he supports Collins’ vote to pass the reconciliation bill. “We’ve got a balanced budget. We’ve got a surplus, we’ve been able to have rural hospital grants and other things.”
“On the federal level, right now our federal government is shut down,” Hatchett added. “So it’s hard for me to comment on anything going on in the federal system because I’m not there.”
Lawmakers from both parties have expressed the need for Congress to address health care. Democrats have drawn a line on health care during the government shutdown in an effort to extend expiring Affordable Care Act subsidies. If the subsidies expire in December, health care premiums for millions would increase.
It’s not just Democrats. Earlier this month, Rep. Marjorie Taylor Greene, a Georgia Republican, called for Speaker Mike Johnson to bring the House of Representatives back into session and address rising health care costs. And Rep. Mike Lawler of New York and several other House Republicans sent a letter to Johnson urging him to address health care costs after the shutdown ends.
Kush Desai, a White House spokesperson, told NOTUS that the Trump administration is “committed to shoring up America’s healthcare system.” He added that the Rural Health Transformation Program tucked into the reconciliation package would help states “adopt meaningful healthcare reform to actually make rural hospitals economically viable again — not just band-aid routine bills for struggling hospitals.”
When asked specifically about the closure of St. Mary’s Sacred Heart Hospital’s delivery unit, Desai pointed to the hospital’s past struggles for the reasons it closed.
“St. Mary’s Sacred Heart Hospital’s labor and delivery unit is closing as a result of a review that began 18 months ago — well before Joe Biden had even dropped out of the 2024 presidential election,” Desai said. “Unfortunately, this hospital only had a 35 percent occupancy rate in 2024, reflective of how rural hospitals have been struggling with chronically low utilization rates despite Medicaid funding dramatically ballooning in recent years.”
Ossoff told NOTUS in a statement that “families deserve access to safe, local care.”
“The closure of St. Mary’s labor and delivery unit due in part to Medicaid cuts in the GOP budget law puts families at serious risk,” Ossoff said. “Georgia has already lost nine rural hospitals in 15 years, and now more are being forced to cut vital services because of Republican-led Medicaid cuts.”
Shere Wilbon, a mother who lives in Royston, Georgia, who had three of her sons at St. Mary’s Sacred Heart Hospital, told NOTUS that she gave birth to her youngest son within 30 minutes of arriving in the delivery unit. Wilbon said that if she had to travel farther, she “probably would have had him in the car.”
She said if she could, she would express to Collins the importance of the hospital.
“I would tell him that it’s important to have small community hospitals in rural areas. And it’s important, especially for high-risk mothers, they have to go far,” Wilbon said. “There should be some kind of funding to help those that need that maternity ward in our area.”