Citing a declining birth rate in San Jose, Regional Medical Center plans to close its obstetrics department at the end of this month — redirecting patients about to give birth to its sister facility, Good Samaritan, or to county-owned hospitals such as O’Connor Hospital and Santa Clara Valley Medical Center.
The move, which hospital officials say has been in the works for the past two months, has sparked a slew of concerns among the department’s 30 employees, as well as politicians and others in the community.
Nurses shared some of these fears at recent county Board of Supervisors meetings, highlighting the damage they say the cut could deal to the already-marginalized East San Jose community where the hospital is based. The California Nursing Association has also hosted weekly protests outside the hospital since mid-April to push for keeping it open.
Maureen Zenman, a registered nurse who’s worked in labor and delivery for Regional Hospital for 29 years, told San José Spotlight she is concerned that the hospital’s emergency room will not be prepared to handle complicated emergency deliveries after she and her colleagues have left.
“A lot of people walk in. We get homeless people, we get moms who didn’t know they were pregnant,” she said. “We’re speaking out for the unborn.”
But emergency room nurse Luis Maciel disagrees that the hospital isn’t prepared for this change. He says he and his colleagues are ready to handle a variety of births — even complicated ones.
“That’s part of (our) training,” Maciel said. “Closing the labor and delivery department down doesn’t mean that we don’t have resources here at Regional.”
Maciel, who has worked at Regional Hospital for 20 years, added that he has assisted with premature deliveries where the baby was as young as 25 weeks.
Neighboring hospitals say they’re prepared to take on the extra patients, too.
Good Samaritan, which, like Regional Hospital, is run by HCA Healthcare, expects to absorb about half of Regional’s roughly 60 births a month. By comparison, Good Samaritan sees just shy of 300 monthly births.
Mark Brown, chief nursing officer at Good Samaritan, says the move happens to dovetail nicely with the hospital’s renovation of its labor and delivery department, including the neonatal intensive care unit and the mother and baby suites.
Nurses, including Zenman, are worried about their jobs. Brown says Good Samaritan will be able to take roughly half of the 30 obstetrics employees from Regional Hospital.
“A lot of those nurses have tenure,” Brown said. “We would have loved to been able to keep them so they can maintain those benefits with us.”
But Brown says the move is necessary. Regional Hospital’s rate of two births per day might actually be a detriment to patients, he adds, as it can leave the nursing staff out of practice with the more infrequent, higher-risk deliveries.
“There’s a memory deficit,” Brown said. “In the grand scheme of things, it’s actually safest to do these procedures at a hospital that does these at a high volume rather than a low-volume hospital.”
Like Good Samaritan, the county-owned hospitals also report that they can absorb the additional patients resulting from the closure.
“We understand that some people may be concerned about having access to obstetrics services in East San Jose, and our hospitals are ready to provide these services,” County of Santa Clara Health System spokesman Maury Kendall wrote in an email to San José Spotlight. “Santa Clara Valley Medical Center and O’Connor Hospital are certified as Baby Friendly with highly skilled and trained staff and excellent birthing outcomes.”
Nurses aren’t contesting that there is good-quality obstetrics care elsewhere in San Jose; they’re more concerned with the travel time women in labor may face as a result of the closure. Good Samaritan is about 15 miles away, while O’Connor Hospital and Santa Clara Valley Medical Center are approximately eight miles. Heavy traffic can add to travel times, they say, especially when their patients don’t have access to a car.
“They’re causing a health desert,” Zenman said.
The nurses aren’t the only ones worried about this. Santa Clara County Supervisor Dave Cortese is among the politicians who have spoken at the weekly protests.
“How far to travel from Alum Rock Avenue to Good Sam after COVID during congested traffic?” Cortese told San José Spotlight on Wednesday. “Would you prefer to be five to 10 minutes from maternity intake or 45 to 60 minutes?”
Cortese said planning a hospital department closure in the middle of a pandemic is less than ideal. Although the Board of Supervisors doesn’t have the power to push back the closure date, Cortese says he’s urging hospital officials to consider a 60- to 90-day self-imposed moratorium on any layoffs or department closures.
“I’m against the closure at this time,” Cortese said. “I contacted representatives of HCA and let them know that the timing of these proposed changes is horrible.”
Birth rates have been on a downward trend not just in Silicon Valley but across the country, according to a National Vital Statistics Report, published last November. Approximately 3.8 million births were registered in the United States in 2018, which represents a 2 percent decline from 2017. The downward trend continued over four years since the last increase in 2014.
In California and in San Mateo and Santa Clara counties, the decrease is also evident. The state saw approximately 450,000 births in 2019 compared with more than 500,000 four years earlier. In Silicon Valley, there were 29,415 births in 2019 compared with nearly 33,000 in 2015.
Local hospitals report similar trends. For example, births at Santa Clara Valley Medical Center, O’Connor Hospital and St. Louise Regional Hospital totaled 941 from a period spanning February through April, a nearly 6 percent decrease when compared with the same period in 2019.
Numbers at Regional have actually bumped up slightly, the hospital reports, from an average of 1.3 births per day in 2017 to 1.7 in 2018 and 2.1 per day in 2019. Hospital spokeswoman Sarah Sherwood says the increase could be attributed to additional outreach by the hospital, but overall demand has been low over a long period.
Contact Carina Woudenberg at firstname.lastname@example.org or follow @carinaew on Twitter.