BAKER CITY, Ore. — Expectant mothers living in and around Baker City, Oregon, are scrambling to change their birth plans after Saint Alphonsus Health System announced in late June it was closing maternity services in the small town of roughly 10,000 people.
St. Alphonsus' obstetrical unit is the only one of its kind in Baker County.
"[Moms are] already terrified, and just to throw there’s nowhere to give birth to your child in there, is just a big unsurmountable obstacle that just tops it all," expectant mother Alisha Alderson said.
THE REASONING
In its initial press release, St. Alphonsus cited a drop in the number of deliveries over the last four years and critical staffing shortages.
There were 128 deliveries in fiscal year 2020, the press release stated. The hospital projects only 75 in fiscal year 2023.
According to the press release, the hospital does not have enough temporary or permanent staff for the obstetrics department. The situation "escalated" because of staff resignations and changes.
Because of various classifications at the state and federal level, An Oregon Health Authority spokesperson said St. Alphonsus is not required to provide maternity services in Baker City.
COMMUNTY PUSHES BACK
The hospital said its decision to close maternity services was "difficult but necessary." Officials originally gave an end date of July 30.
"The hospital broke the news at the same time," Shane Alderson said. "Both of the nurses, doctors and Oregon Health Authority, the county. We were all told we had 30 days to figure it out."
Both Shane and Alisha grew up in Baker City. They are expecting the fifth member of their family in late September. In addition to being parents, Shane Alderson is also the county's chief commission chair.
Shane Alderson, along with several Oregon lawmakers, were able to push St. Alphonsus to stay open another four weeks to Aug 26. Now, they're pushing for another six months.
With all the unknown, a lot of moms do not know what to plan for. Alisha Alderson said she had to figure out a new place to give birth. As of now, she will stay with some family in the Treasure Valley and give birth at a hospital in Meridian.
She also had to change doctors last minute, something she called "heartbreaking."
"One thing I never thought I'd have to consider was whether or not we'd have safe care and a safe delivery," Alisha Alderson said. "I just feel like being anywhere further than a few minutes away from a hospital is just really scary."
If and when Baker City's only maternity unit closes, Shane Alderson said women will have to drive either to La Grande, which is about 45 miles away, or Ontario, which is about 75.
The distances are even further for people who live in more rural areas of the county, he said.
LOCAL DOULA RAISES CONCERNS
Although local doula Shelley Payton said forcing women to drive that long distance to give birth is dangerous at any time during the year, she is very concerned about the winter months.
Payton is the county's only doula, providing emotional and physical support to moms. She said last year, there were more than 30 large road closures that stopped traffic for several hours.
If maternity services do close, Payton said she will be forced to take less patients and stop working for about six months out of the year.
"Not everyone is a brave driver," Payton said. "I am not going to promise my clients that I will travel at 3 a.m. when I've had very little sleep. That's dangerous for me, and it's dangerous for them."
Payton believes the closure would also be deadly for moms and babies because there are less options available for complicated home births. In addition, all of the before and after birth care would also go away.
That means women might not be monitored for certain conditions during their pregnancy, she said.
"Not everybody has a straightforward uncomplicated pregnancy," Payton said. "Doctors are on the lookout for things like preeclampsia, which causes your blood pressure to skyrocket and can be deadly. Actually, that's not something that can be managed at home at all."
She said the closure would impact low-income moms and families mostly because they might not be able to travel as often to get care. Payton believes some moms might end up missing important appointments altogether.
"The added expense of taking extra time off work and more gas money and further travel times just seems incredibly unfair for these moms who don't need one more thing weighing them down," Payton said.
POTENTIAL HIDDEN REASON FOR CLOSURE
Payton, along with everyone else KTVB talked to for this story, said they believe St. Alphonsus might not have been entirely truthful about the reasoning behind its decision.
Kevin Mealy, Oregon Nurses Association spokesperson, said there is a national trend of hospitals closing birth centers in part because they are not money-earners.
"We've seen hospitals look to cut mental health services, to cut family birth centers, to cut sleep centers and other sort of sidebar services that aren't as profitable as, say, knee operations or these other big earners," Mealy said.
At the end of the day, he said St. Alphonsus has a duty to the community figure out another alternative aside from shutting down completely in Baker City. About 90% of the babies in the county are delivered at St. Alphonsus.
"When you know closing will create a maternity care desert and you know that raises the risk of death in that community, you have to really consider that closure and figure out a way to keep providing the service that the communities rely on," Mealy said.
ECONOMIC IMPACT ON BAKER CITY
Aside from impacts on families, both Payton and Alisha Alderson believe St. Alphonsus' decision could change the trajectory of their beloved city forever.
"Why would young families want to move here if they plan to have more children," Payton said.
Alisha Alderson agreed. She believes the closure could "literally and figuratively kill their community."
"We've been told that we're mostly an aging population, but who's going to move here to care for those elderly people if we don't have resources for new families," she said.
POSSIBLE SOLUTIONS
It has been all hands-on deck trying to come up with various short-term and long-term solutions. Payton said she would like to see a smaller, more local hospital buy St. Alphonsus in Baker City.
Some ideas getting thrown out are better than others, Alisha Alderson added.
"One solution I've been given is that babies can be delivered in the ER with the EMS staff," she said. "And I think that, for any mother, that's just a terrifying thought."
Both Alisha and Shane Alderson hope the federal government sends out-of-state nurses, although nothing is set in stone yet. U.S. Sen. Ron Wyden (D-Oregon) said he is meeting weekly with U.S. Public Health Service to get an answer as soon as possible.
If they get outside help for six months, what happens after that time is unknown. Wyden said he is also talking with St. Alphonsus executives every week for the foreseeable future to try and come up with an agreement.
Shane said nobody will stop working until maternity services stay open in the community.
"It's about public safety and the livability of our communities," he said.
KTVB reached out to St. Alphonsus multiple times for an interview. Every time, a spokesperson said they did not have any additional comments.
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