Hiiumaa women can no longer give birth on the island, but transport to the mainland remains unresolved
Hiiumaa Hospital in Estonia stopped providing maternity services on July 1, so women must give birth on the mainland. Who will arrange and pay for travel and accommodation has not been decided.
Women living on Hiiumaa, an island off Estonia's west coast, have not been able to give birth there since July 1, when Hiiumaa Hospital in Kärdla ended its maternity services. Expectant mothers must now travel to the mainland, but there are no clear arrangements for getting them there and back, or for covering the costs.
Why the unit stopped delivering
The hospital has the facilities needed for childbirth but lacks staff. A pediatrician retired on July 1, no gynecologist was available on four days in September, and in October the hospital will have to manage for about a week without an anesthesiologist. All of these specialists are needed to keep births as safe as possible.
Unanswered questions
On Monday, a proposed plan for how the journey to give birth might work was presented to the hospital's board. Hospital Director Riina Tamm said these are only preliminary recommendations and do not resolve the main issue: how mothers will get to the mainland and back, and who will pay. She also pointed to open questions about where women will stay in Tallinn and who will bring them home.
If everything goes smoothly, a patient can reach the Women's Clinic at East Tallinn Central Hospital in three hours and 45 minutes. Ferries already run on the winter schedule, with three hours between departures. A helicopter would take two hours, but only if the weather allows, one is available and its flight-hour allowance has not been used up.
Kärolyn Kivistik of Kärdla is expecting her fifth child on November 8. She will probably head to the capital a week before her due date, since ferries do not run at night and her children tend to be born at night. The family has budgeted nearly €1,000 in extra costs, with renting an apartment near a Tallinn maternity hospital alone costing almost €500.
Responsibility and what comes next
Tamm calls it a regional policy issue and says the state has failed to act: closing maternity units was first discussed in 1998, yet the decision has been left to individual hospitals. Heli Paluste, a healthcare network expert at the Ministry of Social Affairs, said the decision rests with hospital boards because hospitals operate autonomously. She said quality maternity care requires at least 300 births a year, a level only hospitals in Tallinn, Tartu and Pärnu reach, and did not rule out similar decisions soon.
Vivian Arusaar, head of midwifery at East Tallinn Central Hospital, suggested the Estonian Health Insurance Fund could fund hotel-style accommodation at hospitals. The ministry said this would come at the expense of scarce healthcare resources and that help for mothers in financial hardship should come from local governments.
