Baker City maternity ward’s looming closure has expectant parents fearing the worst

The end is near for the maternity ward at St. Alphonsus Medical Center in Baker City, which is now set to close in four weeks. But an out-of-date website meant that the hospital was still advertising its vitality recently.

“‘With more than 90% of all babies born in Baker County arriving at Saint Alphonsus hospital, the Obstetrics and Birth Center plays a crucial role in providing the region’s newborns and their families with the brightest possible start,’” Paige Perilli, whose 1-year-old was born at St. Alphonsus, read from her phone last week.

Doctors and nurses at St. Alphonsus delivered her only child a year ago amidst complications that threatened Perilli’s life. The hospital, which has been delivering local babies for 100 years, serves a population of about 16,000. Unless a solution is found quickly, new parents like Perilli will soon have to travel more than 40 miles to the closest maternity ward.

St. Alphonsus blamed its upcoming maternity ward closure on declining baby deliveries and staffing shortages. Since the initial closure announcement, St. Alphonsus and its parent company, the Michigan-based Trinity Health, have mostly stayed quiet. A representative declined an interview request on behalf of the hospital and didn’t respond to a list of emailed questions about the closure. On Wednesday, St. Alphonsus published a statement announcing that the timeline would be extended to provide “additional time to plan for the transition.”

For expectant parents, the exact timing is just one concern. The prospect of not having a local maternity ward scrambles their plans and creates new fears around what would happen if they face complications during birth. And for the community at large, it raises new questions about whether residents can afford to expand their families and the overall health of a community where delivery options are few and far between.

“I’m scared for the fact that this might weigh into my future family planning,” Perilli said. “I don’t think it’s right. And I’m scared for my friends and the other young women of Baker County. Because we are here. We do exist.”

New fears

Perilli has trouble remembering every detail of her son Max’s birth because she was slipping in and out of consciousness.

She was about two weeks overdue and the team at St. Alphonsus was trying to induce labor. They gave Perilli an epidural to try to relax her, but it didn’t help.

“Fast forward another 24 hours, it was really clear my uterus was failing and it was not up to the challenge,” she said.

Doctors performed an emergency C-section to deliver Max and the whole process cost Perilli two-and-a-half liters of blood, or about half of an average adult’s total blood circulation. And when Max was first pulled out, Perilli couldn’t hear anything.

“‘He’s not crying. He’s not crying. He’s not crying,’” she remembers thinking to herself. “And then eventually, you hear him cry. And you’re like, ‘Oh, thank goodness.’”

Both she and Max recovered and are healthy today, but there’s been some lasting trauma for both Perilli and her husband as she was “forced to face my own mortality.”

If all of this had taken place over an ambulance ride rather than in a hospital room, Perilli worries they wouldn’t have had all the medications and equipment that kept her alive during those critical moments. It’s a hypothetical scenario for Perilli, but it’s a reality parents like Sierra Howerton Lovell will have to soon face.

Howerton-Lovell is expecting her third child in February, and if it’s anything like her previous children, the baby will come quickly. Her last two births were precipitous, meaning her labor was accelerated. Howerton-Lovell said the labor for her second child lasted 16 minutes.

“My water broke and I barely made it to our hospital here,” she said. “And I live two blocks away.”

With the maternity ward set to close long before her due date, Howerton-Lovell’s doctor recently suggested she temporarily move to La Grande to be closer to the Grande Ronde Hospital, which will soon host the closest birth center to Baker City. Between her family and all of her other responsibilities, Howerton-Lovell said it isn’t feasible.

Weather will also play a crucial role for Baker City parents. During the cold weather months, Interstate 84, the only major highway that connects the town to the rest of Eastern Oregon, is often closed due to inclement weather.

While Howerton-Lovell can’t make the move, Jessica Allen is entertaining the idea. She has family in Boise and may opt to move to Idaho to deliver her baby in September.

Allen said her concerns go beyond herself and extend into the community.

“My fear is that the rate of mortality is going to increase in this rural area, because we won’t be able to access things very easily,” she said.

‘It’s astronomically unfair’

For the past few years, Shelley Payton has been working as a doula.

She offers guidance and support over the course of the pregnancy, working with doctors and midwives as needed. She said there won’t be much remaining infrastructure once the St. Alphonsus maternity ward closes.

Payton said Baker City has only one midwife and she doesn’t have enough capacity to handle all the births in the county. Additionally, midwives are required to send their patients to a qualified doctor should their pregnancies run into certain complications.

Payton said she worked hard so that her services could qualify for the Oregon Health Plan, the state’s health insurance system for low-income residents. She worries that some mothers won’t be able to afford to drive to La Grande for their births and prenatal care. The alternative is that when they’re ready for delivery, they’ll have to pay for a costly ambulance ride. And if the roads are closed, the ambulance bill could turn into an emergency helicopter bill.

“It’s astronomically unfair,” she said.

Payton said the problems Baker County is facing go beyond the hospital. She pointed to the Baker City Fire Department, which often only has one firefighter on duty at any given time. And like many other communities across the state, Baker City is seeing affordable housing options dry up as rents continue to rise.

Once the birth center closes, Payton anticipates the community will feel the ripple effect for decades to come.

Unanswered questions

One of the reasons Paige Witham moved to Baker City is because of the St. Alphonsus maternity ward.

She and her husband were living in Caldwell, Idaho, and had access to several different birth centers. But Baker City was her husband’s hometown and they liked the idea of the individualized attention St. Alphonsus doctors would be able to provide them.

The St. Alphonsus birth center delivered her son on June 12, just days before the hospital announced the center’s impending closure.

Witham, who is the daughter-in-law of Baker County Commissioner Christina Witham, said she was “appalled” by the news, but she’s now starting to look ahead to what could potentially replace it.

She’s heard from community members who would like another company to buy and take over St. Alphonsus, but she doesn’t think a sale is likely. Witham said she would prefer a community funded birth center, similar to the Wallowa County Health Care District, which operates a hospital and several clinics.

“The issue comes when you put a dollar sign on a life,” she said.” That’s something that I feel like privatized health care is really focused in. And unfortunately, obstetrics will never be a moneymaker. It just won’t.”

As OPB has previously reported, the hospital in Baker City is operated by Boise-based Saint Alphonsus Health System Inc., a subsidiary of Trinity Health. Headquartered in Michigan, Trinity 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 at the federal level.

In a mid-July letter to the health system leadership, Oregon U.S. Sens. Ron Wyden and Jeff Merkley expressed concerns about maternity care for local patients and asked the system to consider a six-month pause on the closure. Together with local political officials, the senators have proposed bringing in federal nurses with the U.S. Public Health Service Commissioned Corps to keep the maternity ward open for six more months.

So far St. Alphonsus officials’ only response has been to delay the closure by four weeks.

This isn’t the first time St. Alphonsus has cut back services: The hospital closed its intensive care unit earlier this year.

St. Alphonsus’ shrinking services are hurting its standing in the community.

It’s especially affecting Perilli, who works as a physical therapist at St. Alphonsus. She said she’s decided to leave the hospital and seek other work.

“I’m leaving my position because my stomach turns every time I walk in the building,” she said. “Because I feel that we’ve been abandoned.”

Perilli is among the mothers who are now reconsidering whether they want more children. The complications for her first birth meant it would always be a tough choice. But she grew up an only child and didn’t want the same thing for Max.

And with the birth center closing, Perilli is left with a lot of unanswered questions.

“I already have to weigh if I’m taking my life in my hands to have another baby,” she said. “So is it fair to him if he ends up without a mom? Those are things that we have to weigh.”