Dr. Samuel Brown left Merit Health Central in May after nearly two decades delivering babies there, and he said one of the reasons was he no longer felt safe performing C-sections at a hospital with no surgery department.

The south Jackson hospital, which is one of nine Merit Health hospitals in the state, began cutting services last year. One of those was general surgery – another, the hospital’s neonatal intensive care unit.

“I mean, if you do a surgery and get into somebody’s bowel and you don’t have a surgeon on staff, what are you supposed to do?” Brown, who now lives in Florida, told Mississippi Today. “That’s just common sense … It was risky to operate there.”

Guidelines from the American College of Obstetricians and Gynecologists say facilities designated as a Level 2 and higher according to its levels of maternal care model should have a general surgeon available at all times for obstetric patients. The same is not required for Level 1 facilities.

At Merit Health Central, no general surgeons are present at the hospital because the surgery department was cut last year. However, it’s unclear whether the hospital is meeting ACOG’s guidelines – participating in this designation is not required, so it’s unknown what level Merit Health Central would qualify as.

The hospital is a level 4 trauma facility, which are generally small, rural hospitals with the commitment to resuscitate and transfer trauma patients to higher-level facilities.

Brown said he also left Merit Health Central for a “better job” in Florida with more pay.

Melanie McMillan, the marketing manager for Merit Health, said financial hardships have led the health system to take steps to “reduce duplication” across its five Jackson-area hospitals. This has resulted in “the consolidation of some services – including surgeries – with already existing services at other Merit Health hospitals in the Jackson area.” 

The hospital in October ended its operative services, including orthopedics, neurology, urology and general surgery. It closed its burn center – the only such accredited program in the state – in September, and moved its cardiovascular services, neonatal intensive care unit and endoscopy to its facilities in the suburbs. 

McMillan said Merit Health Central currently offers labor and delivery services and a well baby nursery. Three obstetricians deliver babies at the hospital.

A 2019 study in the American Journal of Obstetrics and Gynecology MFM showed among 648,584 cesarean delivery hospitalizations nationwide, surgical errors occurred in almost 2%. The most common were anesthetic errors, errors involving blood vessels and errors involving the bladder.

Brown was disappointed by the decisions being made about the hospital by leadership and the Nashville-based company that owns Merit Health, Community Health Systems.

When the hospital closed the NICU, he was outspoken about the negative impact it would have on high-risk mothers and babies.

“This community is the community that needs doctors … because of obesity and preterm labor, diabetes, hypertension, all that stuff affects pregnancy,” Brown said at the time. “And those are the patients that are going to need high-risk doctors or the NICU. And the fact is, that the NICU is gone. It’s just not a good thing for this community.”

Brown also said an executive with CHS told him the company was not going to put any money into that hospital and would move its profitable operations elsewhere.

McMillan did not respond to Mississippi Today’s questions about the alleged statement.

Merit Health Central, formerly Hinds General Hospital, has long been a health care and employment hub in south and west Jackson — majority-Black neighborhoods that have a higher concentration of people living in poverty than the rest of the city.

According to U.S. Census data, the neighborhood the hospital is located in is 87% Black and 9% white. The median income for families is $29,500. 

Merit Health Central incurred just shy of $16 million in net uninsured costs, or the cost of services for which the patient had no insurance coverage, in fiscal year 2022. That is the largest amount of uncompensated care of any Merit Health hospital in the state that year.

Update 7/15/2023: This story has been updated to reflect Brown’s other reasons for leaving Merit Health Central.