Think Out Loud

Hundreds protest Legacy decision to close Gresham birth center

By Allison Frost (OPB)
Feb. 16, 2023 1:01 a.m. Updated: Feb. 23, 2023 10:37 p.m.

Broadcast: Thursday, Feb. 16

Dr. Mary Afsari-Howard, an OBGYN, speaks at a rally on Feb. 13, 2023, seeking to pressure Legacy Health to reverse its decision to close its Mount Hood Family Birth Center in Gresham.

Dr. Mary Afsari-Howard, an OBGYN, speaks at a rally on Feb. 13, 2023, seeking to pressure Legacy Health to reverse its decision to close its Mount Hood Family Birth Center in Gresham.

Courtesy Jake Thomas/The Lund Report


Legacy Health is planning to close its Mount Hood Family Birth Center in Gresham next month. It serves about 275,000 people in east Multnomah County and the greater Mount Hood community, many of whom are low-income and not native English speakers. The decision drew a protest crowd this week outside the Legacy medical center. Jake Thomas from The Lund Report was there and joins us to talk about the slated closure and what it would mean for the community.

The following transcript was created by a computer and edited by a volunteer:

Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. We start today with a planned closure. Legacy Health has announced it needs to shutter its Mount Hood Family Birth Center in Gresham next month. The decision drew a protest crowd earlier this week. Jake Thomas from the Lund Report was there and he joined us to talk about the slated closure and what it could mean for the surrounding community. Jake, welcome back.

Jake Thomas: Great to be here. Thanks, Dave.

Miller: What is the Mount Hood Birth Center?

Thomas: So the Mount Hood Family Birth Center [is] located in the hospital that Legacy operates in Gresham and essentially it’s where a lot of people go if they need to have birth, that’s where they go to give birth, for the delivery. So that covers a lot of East County, Gresham, Troutdale, as well as a lot of communities on Mount Hood, like Welches, Rhododendron. And that’s really the main place to have a delivery and I think it has 275,000 people it serves.

Miller: How many births has the center seen in recent years?

Thomas: I looked up some numbers for this and according to Legacy, 720 babies were born at Mount Hood Family Birth Center in 2021, and it’s been down, so between 2019 and 2021, births fell 17% from 925 to 720.

Miller: Can you give us a sense for the patient demographics? I mean, who has been using this birth center?

Thomas: Well, if you look at really basic census data for Gresham, Gresham is a little bit lower income than the rest of the state and it also has a higher percentage of People of Color in the area. I’ve talked to some people who work at the hospital, at the family birth center in the hospital, when I was at the rally and they described how quite a few Oregon Health Plan members, which is Oregon’s Medicaid system, as well as a lot of non-English speakers and lower income people use this this facility.

Miller: How has Legacy explained their plan to close down the birth center?

Thomas: So Legacy, what they put out is they say that they’re closing it because of “unsustainable operating losses.” And so they’re saying that they are having a lot of problems that a lot of other health systems have complained about recently, they’re losing money and they’re just having a really hard time making their operations financially viable. They’re having trouble getting staff. And they said that the numbers don’t work with this. They just can’t quite make it work.

Miller: But if I’m not mistaken here, what they’re asking to do is to shut down the birth center but still keep the rest of the center open, including providing prenatal and gynecological care. So the overall center is not closing?


Thomas: As far as a place where you give birth, where you’d have a delivery, their plan is to close that down. But they did issue a statement saying that they are going to continue to have women-centered services. I don’t quite know all the mechanics of just how that works with staffing. But I do know that one of the big reasons that Legacy has stated why they’re closing is that there are four doctors who didn’t find the plan to keep it open feasible and they quit over the operational plan. So I think that was part of it, that you just need to have OBGYNs. And that’s what I’ve heard from some sources, that you just really need to have a birth center staffed around the clock and you have to have adequate staffing all the time because there’s complications. You want the right people there.

Miller: You went to this rally on Monday, put on by health providers and patients who were upset about this proposed closure. What did you hear?

Thomas: A lot of people said that they just felt like that this was not necessary and they’re really getting a bad deal about this. And a lot of concern really is what I heard from a lot of people there. Because if you think about it, if you’re going to give birth, if you’re gonna go into labor and you live somewhere in, say Rhododendron or Welches or somewhere on the mountain, or even in East County, like Troutdale, and you go into labor, you need to get to the hospital real quick. Because otherwise, you might be giving birth in the car. And if there’s a complicated pregnancy, you really have to get to the hospital.

So what they’re concerned about is this family birth center serves East County and if you get rid of it, then that means a drive to - I think Legacy is directing patients towards Randalls Children’s Hospital, the one in Northeast Portland and so that’s quite a bit of a drive. Especially if there’s traffic, it’s a longer drive and if there’s traffic, it’s a lot longer. So a lot of it was really concern about that.

And then, and then also I talked to some staff there and they’re worried that people just aren’t gonna be aware this is going to close, that people are just going to show up there and be like where’s “okay, where’s the birth center?” And they will have to end up giving birth in the emergency room, which is doable, but the staff isn’t trained the same way.

Miller: How has Legacy responded to those geographically specific fears?

Thomas: So they say that Portland is close by and there are hospitals nearby and that they will try to be as available as much as they can and that they don’t want to make this decision. But there are other options for people. Basically what they’re saying is that Portland’s nearby, there are hospitals there and they are still gonna have some services, like we mentioned and that’s, I think it’s basically what they’ve said.

Miller: Is this closure now a done deal? Is it definitely going to happen?

Thomas: No, no, it is not a done deal. So they need to get approval from the Oregon Health Authority. Legacy needs to send a waiver to the Oregon Health Authority to do this, because under state law - and I was just talking with some people at OHA about this this morning - if they want to do that, if they’re a general hospital, they have to have a maternity ward. And so if they want to close this, then they have to lay out the reasons for it and why this makes sense. And one of the notable things is that they have to explain how they’ll justify and how they will continue to meet the needs of the patients. OHA told me today that they have not received the waiver from Legacy yet. So that’s gonna be kind of the next part of the story, the regulatory part, which is the most fun.

Miller: [Laughing] Most fun. Can you put this in the larger context? I mean, how does this proposed closure, the closure of this birth center, fit into the larger healthcare picture right now?

Thomas: The larger healthcare picture is that we’ve been hearing a lot from hospitals that they really are having a hard time financially. A lot of the pandemic, federal and state aid is gone. And they’re reporting losses, they’re saying that they’re just experiencing recent operating losses. And some hospitals [have] said that there’s going to be fewer services for patients if we keep going down this path, that they just don’t have enough staff, they can’t keep staff, they can’t pay, staff wants more money. They have warned that if there’s not serious action taken on this, that there is going to be a reduction in services.

But there’s also a lot of people being very critical of the hospitals. Think about the nurses union. They say that they point out that a lot of these hospital executives are being very well paid and then they’ve had money and they could have planned for this and they just don’t really quite buy this line they’re getting from the hospitals.

Miller: Jake, thanks very much.

Thomas: Thanks for having me.

Miller: Jake Thomas is Senior Reporter for the Lund Report. He joined us to talk about the planned closure of Legacy Health’s Mount Hood Family Birth Center in Gresham next month.

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