The only maternity ward in Baker County, Oregon is scheduled to close permanently on July 31.
It’s the second blow to the local community and hospital. St. Alphonsus closed the intensive care unit at St. Alphonsus Medical Center - Baker City earlier this year.
The hospital has been delivering babies for more than 100 years. It serves a population of about 16,000. The next closest hospitals with labor and delivery services are 44 miles away in La Grande or 74 miles away in Ontario.
“It is a devastating blow to the community,” said Baker County Chair Shane Alderson.
Alderson’s daughter was born at Saint Alphonsus - Baker City five years ago. His wife, a local hospice manager, is pregnant with their second child and due in September.
“We were expecting to drive the, I guess it’d be about a half a mile, from our house or my office when the time came,” he said.
Now, Alderson and his wife need to find a new ob-gyn, and decide whether to stay home and hit the road when she goes into labor, or plan an extended stay in La Grande, Ontario, or Boise ahead of time to be ready.
The hospital in Baker City is operated by Boise-based Saint Alphonsus Health System, Inc., a subsidiary of Trinity Health. Headquartered in Michigan, Trinity is one of the nation’s largest Catholic nonprofit health care systems. It operates 88 hospitals and dozens more outpatient clinics. The planned maternity ward closure in Baker City is one of at least three cuts to labor and delivery services at Trinity-owned hospitals that have been reported in the press so far this year.
According to the Oregon Health Authority, Saint Alphonsus - Baker City isn’t required to provide maternity services because it is designated as a Low Occupancy Acute Care hospital at the state level and as a Critical Access Hospital (CAH) at the federal level. That’s a different designation than the one held by Legacy Mount Hood Medical Center, a hospital in East Portland that was recently prevented from shuttering its birth center by state officials. That urban birth center re-opened on June 21.
Back in Baker City, Anderson hopes he can work with Saint Alphonsus in his capacity as county chair and find a way to get health system leaders to reconsider. He says the closure of the maternity unit is “a very frightening prospect” for his family.
And Alderson fears that for people in his community who are less well off, it could be disastrous. He’s particularly concerned about single mothers and teen parents.
“The added burden of where do I go to have this child? It’s got to be just huge,” he said.
Saint Alphonsus noted the lack of transportation options for Baker City residents in a 2020 report highlighting the benefits the health system provides to local communities.
“As there are no local taxicab or shared ride services in the region, transportation operations are limited, causing many residents needing off-hours transportation to not be able to access appropriate healthcare in a timely manner,” the report states.
Anderson is also concerned that weather and geography will trap pregnant people in the town, where they’ll have to give birth in the emergency department.
The city sits at 3,451 feet elevation in a valley between the Elkhorn mountains to the West and the Wallowas to the East. While the town is on 1-84, the freeway has historically shut down frequently in eastern Oregon due to crashes and winter weather.
“In the wintertime, it may not be geographically possible to get to another location,” he said.
Saint Alphonsus declined an interview request. In a press release, the health system cited a declining number of deliveries at the hospital as a reason for the closure.
State data shows an average of 119 deliveries per year took place at Saint Alphonsus Medical Center-Baker City between 2013 and 2022. The average in the past four years fell to 112.
Saint Alphonsus also said it has been unable to staff the obstetrics department adequately with permanent or temporary staff, making it unsafe to continue operating.
“The urgency of the situation has escalated due to recent staff resignations and changes,” the press release states.
Health systems across the country have shuttered maternity units in recent years, citing staffing shortages and the cost of providing maternity care exceeding the revenue it generates. The problem is particularly acute in rural counties, where a higher percentage of the population tends to be insured through Medicaid. More than half of rural counties don’t have a hospital with obstetric services, according to a 2022 Government Accountability Office report.
The other closures just among Trinity affiliate hospitals this year include plans to shutter a maternity unit in Troy, New York and the closure of a maternity unit in Plymouth, Indiana.
In 2022, a hospital affiliated with Trinity Health in Ft. Lauderdale, Florida closed its maternity unit. That year, another Trinity affiliate, Johnson Memorial Hospital in Stafford Springs, Connecticut, was fined $394,000 by state regulators for improperly permanently shutting down a maternity unit during the pandemic. The hospital is appealing that fine.
Trinity Health did not respond to a request for comment.
In its most recent quarterly financial report, Trinity said it is diversifying its business to continue a shift away from inpatient care toward outpatient care, pharmacy, and digital telehealth services.
The report states that Trinity is focused on revenue growth opportunities, labor retention, and “continued cost reduction plans.”