Birth center closures indicative of nursing shortage

Posted May 4, 2023

By Benjamin Larkin and Carmen Gonzalez

Cub Investigative Reporters

Legacy Mt. Hood Medical Centers family birthing center's closure on March 17 due to staff shortage and high operating costs has been denied by state authorities, with the facility planning to reopen within 90 days.

Mt. Hood Medical Center is a hospital in Gresham established in 1959. It is a 115 bed facility owned by the nonprofit Legacy Health and provides emergency, surgery, radiology, breast health, cardiac rehabilitation, and orthopedic services. Legacy Mt. Hood Medical Center closed its family birthing center on March 17, 2023. Legacy Health cited staff losses especially staff trained in the field of birthing and prenatal care as well as financial losses from the covid quarantine with a drop in overall birthrates in the region. Legacy Health also stated that just 16% of births in the area occur in the birth center, roughly 700-1000 per year, leading them to question its necessity and economic viability.

Mt. Hood Legacy Birthing Center’s closure had not received state approval with the center recognized as on divert status which means they were registered as diverting patients to other hospitals, instead of being shut down. There are multiple conditions necessary for shutting down a medical center which have not been fulfilled by Legacy Health; this could have resulted in sanctions as well as other legal action, including Legacy Health’s licensing and certification being revoked in the state of Oregon. The Oregon Health Authority is requiring the Mt Hood Legacy Birth Center to be reopened within a period of 90 days following a state investigation into the legality of the Birthing Centers' closure. The Oregonian Quoted Rep. Zach Hudson as saying that the birth center’s reopening is a “Big victory for the community” and “this shows that the process and the protections we put in place actually worked.”

The attempted closure of the Mt. Hood Legacy Birthing Center has caused logistical and staff issues in maternity care, especially the delivery process for those in Gresham who relied on the center. At best these issues could be an inconvenience. At worst a newborn or expecting mother could die or suffer serious health issues as a result. Gresham’s emergency medical system in East Multnomah County is already overworked and short-staffed with long wait times, so relying on emergency transportation services such as ambulances is not a viable option for many high-risk delivery situations. 

Many of the Mt Hood Legacy Birthing Center’s employees have already found employment at other local medical practices. Fortunately, most have expressed a desire to return to the birthing center including long-term employees with decades of experience. The birthing center, despite returning personnel, will still be facing staff shortages that were an important factor in the facility's attempted closure. While Oregon currently experiences a near-critical shortage of nurses, especially nurses trained in delivery and prenatal care. It is unlikely that the birthing center's staff shortages will be alleviated anytime in the near future.

East Portland, including the David Douglas School District, has been affected by the state-wide staff shortages and increases in the cost of medical care. Clinics and hospitals throughout Portland are understaffed at every level with physicians, nurses, and desk workers all in short supply. There are low-income communities in east Portland that made use of the Mt Hood Legacy Birth Center both for delivery care and affordable prenatal and postpartum care. The center's temporary closure will worsen the medical situation in East Portland by removing a close and affordable option for many families, placing more stress upon other medical centers that local communities make use of, such as Randalls Children's Hospital, which has served as the main alternative since the Mt Hood Birthing Center’s closure.

Birthing centers throughout the nation have been shut down with hospitals citing staff shortages and financial losses as a result of the covid-19 pandemic. The areas most impacted by the closure of these centers are rural and low-income areas which even before the pandemic had been experiencing staff shortages and a general lack of funding. There are now many regions where prenatal and delivery care services are simply not available with overstretched emergency services unable to fully attend to each and every situation. Rural areas are the most heavily affected with many having to travel long distances to reach a hospital or clinic and many rural hospitals lack the equipment and personnel to deal with birth complications. Shutting down birthing centers will exacerbate the issue and cause more deaths and birth complications.

The David Douglas School District is home to many low-income families who will be harshly affected by increases in the cost of medical care as well as reduced access to medical care. Especially in the field of delivery care in which a lack of access to quick medical care could lead to birth complications and loss of life. The shortages of nurses and physicians and financial losses from the Covid quarantine have motivated more and more medical centers throughout the area to shut down certain functions and rely on a small overworked staff. Fortunately, the Mt. Hood Legacy Birthing Center will reopen and relieve a degree of the pressure its closure placed upon East Multnomah County, as well as offer employment opportunities for nurses within Portland and Gresham. 

On a positive note, the Oregon Nurses Association said, on their official website, ‘We are incredibly grateful to our patients, our community and our coworkers for their hard work and activism. Together we have turned the tide and saved our family Birth center.”