Nurses, physicians and community members came together Saturday afternoon in defense of Watsonville Community hospital’s mother-baby service lines, which include labor and delivery and neonatal intensive care, at a town hall organized by nurses.
Pajaro Valley Health Care District is considering closing the labor and delivery and NICU service lines at WCH due to ongoing financial issues exacerbated by H.R.1, a federal law that changes federal spending for healthcare and welfare.
The Pajaro Valley Health Care District has not confirmed a date to release its final recommendation on closing service lines, but a discussion is on the agenda for the board meeting on Oct. 28.
Around 90 people were in attendance for the Care Not Cuts town hall on Oct. 24 led by intensive care nurse Roseann Farris, who has worked at the hospital for 30 years. Farris called on community members to attend the Oct. 28 PVHCD board meeting and contact board members expressing their support for the mother-baby service lines.
She presented the hospital’s history of cuts and financial issues and addressed the H.R. 1 cuts, which she said will cut vital healthcare to some of the most vulnerable patients and communities. At Watsonville Community Hospital, the cuts are expected to cost the hospital $4 to $6 million over the next year and close to $100 million over the next 10 years, according to a presentation by CFO Julie Peterson at the Sept. 22 PVHCD board meeting.
“Regardless of these looming challenges, we are not going to somehow cut our way to a better place by closing the women’s and children’s services department,” Farris said.
A panel consisting of a range of WCH mother-baby service providers presented their concerns and perspectives on the situation.
Thanh Pitchforth, a labor and delivery nurse, and Heather Brown, a NICU nurse, spoke about the importance of experience and regular practice in their units.
Obstetric emergencies, such as when the shoulder of a baby is stuck in the birth canal, require specialized experience to treat safely and effectively. For the mother, this likely leads to an emergency cesarean section and can develop into a postpartum hemorrhage, a dangerous bleeding after childhood, both of which take a team to treat. For the baby, it requires a neonatal nursing specialty and practiced skill to restore oxygen levels, according to Brown.
Minutes matter for maternal outcomes, affecting things such as postpartum depression, post-traumatic stress syndrome and short-term and long-term disabilities, Pitchforth said.
“You can’t be a skilled registered nurse in any nursing specialty if you are not practicing those clinical skills on your shift on a daily basis,” Pitchforth said. “What I and what any experienced labor nurse would also worry about is … what could happen to a mother and child in an emergency situation.”
Brown said she is concerned about the chance for “catastrophic outcomes” should a neonatal or obstetric emergency happen in the emergency department.
Transportation, both for the mother in labor and for transferring premature babies, was a concern among panelists and community members. Commute times to the neighboring maternity wards in Salinas and Santa Cruz can take up to an hour and many low-income families share vehicles or do not have access to a car, according to Pajaro Middle School community school specialist Laila Vazquez.
Madhu Raghavan, who worked as a physician in Watsonville for 39 years, called on major companies in neighboring Silicon Valley to step up financially.
“Can some of those tech companies help the small farmer communities where they benefit from all our products?” Raghavan asked. “All that is very small change for them.”
Raghavan and Farris also called for attendees to vote yes on Measure E, the temporary half-cent sales tax created to protect the health and welfare community services threatened by federal cuts.
Mother and baby units generally do not make money for hospitals, a pattern that is true at WCH, where the combined units lose an average of $27,000 a day, according to PVHCD Chair Tony Nuñez. Andrew Harkins, a pediatric hospitalist at WCH, said the hospital is becoming a victim of the imbalance system caused by the underlying incentives of our medical system, which prioritize profit-generating care.
“It’s not about loss,” said Jessica Avila-Miller, a nurse in the telemetry unit. “It’s a moral obligation for us to support women and children.”
During the general forum period, some community members expressed concern over the board making a recommendation before the Nov. 3 election results for the county’s Measure E and the state’s Proposition 40 are released. Prop. 40, commonly referred to as the “Billionaire Tax,” is expected to generate tens of billions in revenue for healthcare over 5 years, according to the California Budget & Policy Center.
Melanie Kendall, a labor and delivery nurse, said the hospital’s partnership with Salud Para La Gente to provide culturally-responsive care, such as doulas, to Spanish- and Mixtec-speaking patients is something other hospitals in the county don’t have.
“It is so hard to be in one of your most vulnerable states delivering a child,” Kendall said. “It is crucial that Watsonville Hospital stays open, that these patients have somebody to advocate for them.”
