by Jane Winik Sartwell, Carolina Public Press
May 30, 2025

Nearly 2,000 women in Harnett County give birth each year. But the county’s only hospital no longer has a space fully equipped for them to deliver. 

Betsy Johnson Hospital in Dunn closed its maternity care unit in 2023, citing financial trouble. 

Harnett County women must now travel to seek care, or give birth in an unequipped emergency room. Both scenarios leave both women and their children at risk. 

The closure of the labor and delivery unit at Betsy Johnson Hospital — owned and operated by Cape Fear Valley Health — marks the 10th such closure in North Carolina over the last decade.

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Twenty percent of those closures are at the hands of Cape Fear Valley Health. The health system shuttered another maternity unit in south-central North Carolina in 2018. 

It’s a growing problem that was previously detailed in Deserting Women, a three-part Carolina Public Press investigation in March that examined state data on every North Carolina hospital over the last decade. CPP found that hospital systems have systematically centralized services in urban areas while cutting them in rural ones. 

Because the Harnett County closure occurred after the period covered by the data used in that report, it was not included in the series. But this case is no different from the others. 

Women who once would have sought care locally at Betsy Johnson are referred to the health system’s flagship facility in Fayetteville, Cape Fear Valley Medical Center, according to DHHS. 

That’s a 45-minute drive.

Larger facilities, like the one in Fayetteville, can stomach the financial losses associated with maternity care and treat higher-risk births, which bring in more money.

For women in labor, however, that 45-minute journey can feel like an eternity. It means navigating major highways, some of which are plagued by construction work and persistent traffic woes. Doing this during contractions means worrying about whether they’ll make it in time, and facing the very real possibility of giving birth on the side of Interstate 95. 

For those without reliable transportation or who experience complications, the distance becomes even more dangerous.

A new maternity desert for North Carolina

This closure cements a new maternity care desert that was already growing in the region surrounding Harnett County. 

In nearby Hoke County, two hospitals are present, but neither provides labor and delivery services. 

Hospitals in Johnston and Sampson counties have both reduced service in recent years, according to the License Renewal Applications each hospital submitted to DHHS. 

And just five years before the closure in Harnett County, Cape Fear Valley Health shuttered its maternity service in Bladen County at Cape Fear Valley Health Bladen County.

As a justification of that closure, the health system cited the extensive damage caused by Hurricane Florence. 

These individual closures and reductions in service amount to a wider gap across the region. Cape Fear Valley Medical Center in Fayetteville, which sees more than 5,000 deliveries per year, now receives maternal patients from Harnett, Hoke and Bladen counties.

The financial math in Harnett

Cape Fear Valley Health says the closure at Betsy Johnson is a result of “declining demand for maternity services, recruitment challenges and financial realities.” 

Framing service closures as a financial inevitability is a common refrain for hospital systems. 

Maintaining specialized, 24/7 staff, up-to-date equipment and adequate space for a labor and delivery unit generates substantial expenses. If a hospital begins to see declining numbers of births, due to an aging or shrinking population in the area, per-birth costs increase dramatically. 

No regulatory structure exists in North Carolina to keep hospitals from balancing pesky financial equations like this by reducing, or fully eliminating, maternity and other related care, even when they previously received a certificate of need from the state to provide that care. 

“While this chapter may be closing, the impact we have made together will continue to resonate in the lives of those we have cared for,” reads a press release from Cape Fear Valley Health. 

“Our commitment to the health and well-being of our community remains steadfast, and we look forward to continuing to serve our community in other important aspects of (health care).”

According to the hospital, they are maintaining gynecological, prenatal and post-natal care in Harnett County.

The closure doesn’t mean babies won’t be born at Betsy Johnson. If a woman in labor cannot be transferred to Fayetteville in time, she will have to deliver in Dunn. Those deliveries will just be less safe.

“Hospitals that close L&Ds will still have deliveries in their hospital,” Andy Hannapel, a family medicine doctor for UNC Health, told Carolina Public Press. 

“It will be in their emergency departments that are less well equipped to provide the care that women and families need in pregnancies and with deliveries.”

Hannapel works at a hospital in a county adjacent to Harnett: UNC Health Chatham. There, counter to the dominating trend in the state, a new maternity care center opened in 2020. 

That success story proves it’s possible for health systems to overcome the financial inevitabilities associated with delivering babies. But not all have the deep pockets of UNC Health. 

For now, pregnant women in Harnett County face a reality that is becoming increasingly common across rural North Carolina: longer drives, fewer options and emergency rooms that were never designed to deliver babies. 

This article first appeared on Carolina Public Press and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

The post Harnett Co. NC copes with recent loss of hospital maternity unit appeared first on carolinapublicpress.org

Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Left

The content highlights the closure of rural maternity care units and the resulting public health challenges, focusing on the negative impacts of financial pressures and healthcare centralization on vulnerable populations. It critiques systemic healthcare issues while emphasizing the need for community care access, which aligns with concerns often raised by center-left perspectives advocating for expanded healthcare services and equity. However, the piece remains fact-based and does not explicitly call for specific policy changes or take a markedly partisan tone, positioning it near the center-left of the political spectrum.