We found out in August that the Mad River Birth Center was, after more than fifty years, no longer going to be offering maternity care/birth services after October (the hospital plans to stay open otherwise). While shocking (and the timeline was way too abrupt), it was also not surprising, given the hospital's nursing staffing struggles in recent years as well as trends in maternity care in this country. There are many expanding "maternity care deserts" in the U.S. due to rural community hospitals deciding to cut obstetrics programs, as high-quality maternity care is not a money-maker (in large part due to horrifically low insurance reimbursements for women's care and birth).
Over the last couple of months, I've read a million e-mails and attended "transition" meetings about a shift in birth in the county-- with all hospital births in the county now heading to Providence St. Joseph's Hospital in Eureka, which has also made national news due to a lawsuit involving other less-than-optimal treatment of a local woman with a impending loss of a much-desired but high risk pregnancy due to ethical/religious directives. Redwood Memorial Hospital in Fortuna closed down in 2021.
I just completed my last call shift and attended some of the very last births (one vaginal, one scheduled cesarean birth in my final hours!) at the hospital where I've worked for thirteen years alongside many incredible nurses and birthworkers. I've been a part of some truly miraculous and joyful experiences of so many families, and also sobbed in the hallway with some tough births and traumas (especially during the COVID pandemic). I chose to have my two children there. I went from a brand-new attending to a (mostly unflappable) veteran, crafting my birth style in a way that I'm proud of-- aiming to support patients for empowered, physiologic birth whenever possible (and ruffling some administrative feathers from time to time when fighting for patient bodily autonomy). I had one last partial night of sleep in the tiny (and cold) call room where I've spent many a night (most weeks, in fact) over more than a decade. It's hard to to believe we're actually done. I wish lots of luck to the ER docs and nurses for the unplanned/out of hospital births/transfers and other pregnancy bleeders, which will inevitably hit the hospital doors (and, most of all, I pray for the women and babies, who will bear the burden of the risk and outcomes with the hospital's decision).
I didn't actually leave the unit with tears today, but feel somewhat numb, and am trying to stay neutral (cautiously optimistic?) about what the change will bring to me personally. I will start providing obstetrical care and attending births with an expanded group of Open Door providers in Eureka starting in November. The hospital is about twice as far from my house and we are shifting to more of a organizational laborist model. For now, I'm looking forward to not to have to multitask constantly, juggling both outpatient and inpatient patient care including labors as well as and nurse calls from clinic and the hospital at the same time. I'm excited to not be "the call person" the ER calls periodically, because my former hospital didn't staff or pay OBGYNs for providing consult care. I'm so happy to not to have to be on for ninety six straight hours of OB call (?ever again) and to have fewer call shifts per month (while possibly being busier when working). I'm looking forward to working at a hospital which seems to have a better and safer staffing model-- for nurses, for surgical crew, for anesthesiologists, for doctors, and for patients, even though there will be some growing pains with the added birth volume.
However, it's hard to teach me (an old dog) new tricks-- I'm intimidated by the new hospital's medical records system, and have to had to jump through a ton of hoops with log-in training, EMR training, and in-person "orientation" to come soon. I have some degree of anticipatory anxiety about being a "newbie" in a different system, with different nursing staff and work-flows, as well as supervising residents, rather than working as an individual on my own. However, I know it will get easier with time.
I'm hoping that the state of California and Partnership Medi-Cal can work to encourage better support of local women's birthing options (Moonstone Midwives birth center is another local player, offering low-risk women out-of-hospital births. However, as we know, sometimes birth turns not-low-risk rather quickly and many women prefer to deliver in a familiar homey hospital, which we've now lost for our community). I truly feel that supporting women and families is my calling and professional passion so, for now, I plan to keep my "foot in the door" of local birth work-- until it becomes personally or professionally overwhelming or unsustainable while still juggling a family practice panel.
We also have an important election coming up in seven short days, where women's rights are atop the ballot with repercussions that will be far-reaching if the preferred candidate does not win. While I am fairly pessimistic about the outcome, due to the number of (often clueless about women's health and autonomy) men who still run most systems in this country and who vote in appalling patterns (as well as some serious past election trauma, ahem, 2016), I sincerely pray that we could have a different future-- where all women in this country are granted the rights, choices, and health care we all deserve!
Group pic (a few generations of birthworkers)
