St. Charles plans to close birthing center in Redmond hospital due to low volumes of use.

FILE PHOTO - John White, president of St. Charles Madras and PrinevilleExpectant mothers in Jefferson County will have only two area options for delivering their babies, starting next summer — St. Charles Madras or St. Charles Bend.

St. Charles Health System announced Oct. 29, that its board of directors voted to close the Redmond Family Birthing Center.

"This was not an easy decision to make," said Board Chairman Dan Schuette. "But as a health system, we must take into account the needs of our entire region and try to best serve as many people as possible. By closing the Redmond birthing center, we'll not only be able to further enhance the services we provide to mothers and babies throughout Central Oregon, but also we'll be able to invest in areas we heard are badly needed for women like behavioral health and geriatric services."

The health system's leadership team made the recommendation to the board of directors to close the birthing center after a task force composed of community and medical providers spent 10 months evaluating the women's and newborn's service line. That group found the health system's three birthing centers in Bend, Madras and Redmond are usually at less than 50 percent capacity and that the low volumes led to staffing challenges.

Lisa Goodman, public information officer with St. Charles, pointed out recently that the occupancy rate of Bend's birthing center is about 48 percent and the rate in Redmond is about 43 percent.

"If we were to consolidate those two birthing centers, I think that would put us in the ballpark of 60-plus percent in terms of occupancy, which is kind of what we strive for in order to achieve efficiencies, staffing and delivery of services."

Planned enhancements

As part of the changes to women's and newborn's services, an obstetric hospitalist program will be created at the Bend hospital to provide care for laboring patients and manage obstetric emergencies, which hospital leaders say has been shown to improve clinical outcomes.

John White, the new president of St. Charles Madras and Prineville, said improvements will also include work on a Level 3 nursery, which he says is a higher level of care for newborns who need more intensive care.

"That is a big deal," he remarked.

Midwifery services will be added as well, according to hospital leaders, with the intent of allowing women with low-risk pregnancies to have additional labor support. In Madras, resources will be provided with plans to enhance nursing skill and education. The St. Charles Center for Women's Health in Redmond will remain open to provide prenatal and gynecologic services.

At this point, no enhancements at the Prineville hospital are included in the recommendation.

"I don't think so, yet," White said. "The Prineville expansion with intermediate care and the rehab services program has been on the top of our priority list."

Pioneer Memorial Hospital, the hospital serving Prineville prior to the opening of St. Charles Prineville in 2015, stopped providing obstetric services at the beginning of 2010.

At the time, an estimated 5,000 babies had been born at the PMH hospital since 1952. According to Don Wee, the hospital's executive director at the time, the decision was not a financial decision, but was instead made because of a sharp decline in the number of primary care physicians available to provide services.

The shortage in OB doctors was not unique to Prineville, but rather part of a nationwide trend where fewer primary care physicians were available overall and many of them had chosen other specialties.

The decision came on the heels of record birth numbers in Prineville in 2007 and 2008.

Birth numbers declining?

The 2018 decision comes at a time when births are expected decline. In reviewing demographic data, the task force found that during the next 25 years there will be an increase in women who are ages 45 to 65, reducing the demand for birthing services in the region.

"Combining birthing services in Bend will make for a more efficient, high-quality care model for our region," said Dr. Barbara Newman, a board-certified OB-GYN and medical director of the St. Charles Center for Women's Health in Redmond. "And it's safe. A large body of research suggests that drive time of an hour or less to a birthing center is reasonable. Our Bend hospital also has a NICU, which means babies born there are going to have immediate access to a very high level of care."

Future plans

In the coming months, the health system will begin working on its implementation plan, including hiring additional staff and determining the future use of the 12-bed family birthing unit in Redmond.

"We're going to partner with our caregivers throughout this process to ensure this is an effective transition," said Iman Simmons, St. Charles' chief operating officer. "Working together, we're going to provide the best care possible for our mothers and babies. No one is going to lose their employment."

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