Kate Williams in the hospital. Photo courtesy of Jodi Williams

Kate Williams in the hospital. Photo courtesy of Jodi Williams

“There was no choice. I had to do exactly what that doctor wanted.”


Jodi Williams expected to give birth to her third child in a hospital. The 37-year-old and her husband, Matt, planned to drive to Augusta Health in Fishersville, deliver a baby girl and drive home the next day.

Instead, she delivered baby Kate on the side of Interstate 81. Williams was on the road for 20 minutes before her husband pulled over to deliver Kate near exit 214. They were outside Greenville, Va., about 15 minutes from Fishersville.

“He just caught [the baby] and jumped back in the car,” she said.

The couple were on their way to the nearest labor and delivery unit 38 miles north.

For Williams, the drive to Augusta Health was longer than the time it took for her to deliver. She made it there, but with Kate in her arms instead of in her belly.

When she arrived at the hospital, doctors discovered that the baby had overly thick blood because she had been attached to the umbilical cord for too long. She was one point above normal, Williams said.

Williams and her doctor in Lexington thought the condition would work itself out over time, and they disagreed with the approach that physicians took at Augusta Health.

“They were doing bloodletting. They had an IV in her. They were doing all these solutions,” Williams said.

Williams was caught in the middle: Her doctor in Lexington told her to check out of the hospital. But the physicians at Augusta Health threatened her if she did.

“I was told when I wanted to leave that Child Protective Services would come in,” she said. “There was no choice. I had to do exactly what that doctor wanted.”

Williams is one of many women in Rockbridge County who face obstacles in accessing health care because of the area’s limited choices.

Beyond just labor and delivery, women struggle to find obstetric care. Lexington lost its last obstetrician/gynecologist almost a decade ago. Without a permanent obstetrician in Lexington, women are forced to travel to Fishersville for routine reproductive health checkups.

The situation is exacerbated because many doctors don’t want to practice in rural areas. After graduating from medical school, they are burdened with debt. They can’t make enough money and often work long days and nights on call without many other doctors to help.

Operating a private practice in a rural area gives doctors more freedom and flexibility. But such practices are finding it increasingly difficult to resist large health systems, such as Augusta and Carilion. They are gobbling up smaller practices, and changing the business of health care.

And even if women can get an appointment with specialists with Augusta or Carilion, they can’t get to Fishersville or Roanoke if they are among the 12.8 percent of Rockbridge County residents who live in poverty. They may not have a car to get there.

It means that women – young and old, rich and poor – struggle to get the care they need.


Without a labor and delivery unit in Rockbridge County, women are forced to travel to Fishersville or Roanoke to deliver a baby. Some women can make the trip, but others end up delivering while trying to get there. As challenges become more apparent, women are embracing alternatives to traditional hospital births.


Nearly 10 years after the birthing center at Carilion Stonewall Jackson Hospital closed, Rockbridge County still doesn't have a full-time OB-GYN. But despite the challenges this brings, the community has learned to adapt.


As the health care industry becomes increasingly complicated, Lexington's doctors are facing a difficult choice: to remain independent or join a larger health care provider like Carilion and Augusta Health. These providers are playing an increasingly larger role in the Lexington and Rockbridge area, with mixed consequences for local residents. 




The Uninsured and Seniors

Rockbridge County is designated as a medically underserved community. These two groups--the uninsured and the elderly--can have trouble accessing health care within the county.