Community members packed a Redmond City Council meeting Tuesday to voice opposition to a proposal to close the family birthing center at St. Charles Redmond. While their emotional pleas resonated with councilors, hospital officials laid out a data-heavy financial and clinical case that the closure could improve outcomes for patients and reduce costs.
St. Charles officials say both the Redmond and Bend birthing centers have been operating at less than half capacity, driving up costs for patients and insurance plans. St. Charles has some of the highest costs for births in the state — 20 percent higher than the state average and nearly twice the lowest cost hospital in the state.
“It’s not unusual for each of those sites to have no inpatients,” said Aaron Adams, president of St. Charles Redmond and Prineville.
The hospital system convened a work group to find a way to cut costs and improve quality of care for pregnant women. The group forwarded three proposals to the hospital’s executive committee, including one that would keep the birthing center open for low-risk births. But hospital officials indicated a proposal to close the birthing center in Redmond and shift those deliveries to Bend was the most likely to be approved by its board of directors.
The board could make a final decision later this year, most likely at its December meeting.
The savings from closing the birth center, Adams said, could be shifted to provide other services in great demand in Central Oregon including geriatrics, behavioral health and skilled nursing care.
St. Charles officials said demographic trends suggest a lower demand for deliveries in the region. While the Redmond birthing center delivered more babies than ever in 2017, the numbers this year are already trending lower.
“It doesn’t pencil out,” said Dr. Robert Pfister, a neonatologist at St. Charles Bend. “We’re taking care of 1.5 babies per day, and we consume resources of 10 to 12 professional employees. … I can tell you clearly and honestly, we’re losing money.”
Dr. Barbara Newman, clinical director of women and children’s services at St. Charles Redmond, said that by expanding the Bend birthing center to accommodate the births now happening in Redmond, the hospital could provide round-the-clock access to nurse midwives, obstetricians and a dedicated obstetric emergency department.
“These initiatives have been clearly shown across the country to increase patient satisfaction, decrease bad outcomes and improve safety for moms and babies,” Newman said.
Because the Bend hospital has the only neonatal intensive care unit in the region, the consolidation in Bend would result in 50 fewer high-risk transports of mothers or babies and decrease the number of separations of mothers and babies, she said.
While opponents have raised concern about the added driving time to Bend, Newman said last year there were only five deliveries that occurred within three hours of the onset of labor.
“Will precipitous deliveries increase with this proposal? I guess that’s possible, but as the data shows, that’s perhaps not the safety issue as it might seem to be at first thought,” Newman said.
Opponents of the closure countered with arguments about access and patient choice, trying to reframe the discussion from a financial one to one of patient preference.
“We all know that margins are tight, but it is more than that,” said Amber Loredo, a nurse who works at the Redmond birthing center. “We want the people who want to deliver in Redmond, who want to deliver in Bend, who want to deliver in Madras to have that choice.”
The Oregon Nurses Association chapter in Redmond has been a vocal critic of the plan, and has marshaled community support to oppose it.
An ONA spokesman said the union had collected more than 2,500 signatures opposing the closure, and an online petition has garnered more than 1,350.
The council heard impassioned pleas from both health providers and community residents in support of keeping the birthing center opened.
“The staff in the Redmond birthing center are unmatched. I have never felt better taken care of,” said Julie Gilbertson, a Redmond teacher. “As a mother what I wanted for my birth experience was that it was safe, I was cared for and I could be close to my family, not saving money.”
Madeline Drescher, a birth doula in Central Oregon, said two of her clients recently transferred their care from Bend to Redmond.
“Birthing women need to feel safe and cared for, when they have a baby,” she said. “For some it’s safety, for others it’s the experience, but they are equally important.”
Councilor Jon Bullock summed up the evening as a debate between empirical data and anecdotal evidence.
“I know what the empirical data says, but the anecdotal evidence, the needs of the people, the needs of the community can sometimes outweigh that data,” he said.
“But I also know that if our community says we’re OK, if this is 20 percent higher than the state average, we want to have our babies here, then I want that voice to be heard.”
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