LA Hospitals Struggle as Maternity Ward Closures Lead to Increased ER Births
TL/DR –
The closure of maternity wards in Los Angeles since 2014 has led to an increase in emergency room births and increased pressure on remaining maternity wards. Research shows prenatal care access decreases when maternity wards close, which can lead to complications for complex pregnancies that end up in the emergency room. The situation is particularly dire for Black women, who are three times more likely to die from pregnancy-related complications and have the highest severe maternal morbidity rates in LA county.
Sigita Cahoon works tirelessly at LA’s general medical center
In September 2024, Sigita Cahoon, the hospital’s vice-chief of obstetrics and gynecology, delivered three babies between 3 am and 6 am at Los Angeles general medical center (LA GMC). With maternity wards closing across Los Angeles, emergency rooms like LA GMC face increasing patient loads.
Closure of maternity wards in LA
LA GMC in Boyle Heights has seen more than 1,400 women seeking labor and delivery care through emergency room doors between 2016 and 2023. LA county witnessed the closure of at least 21 maternity wards since 2014. This led to a rise in emergency room visits for labor and delivery, despite a drop in the number of babies born in the county. Data from California’s department of health care access and information shows more than 26,500 people, about 64% of whom were Latino, sought birthing care at an LA county emergency room between 2016 and 2023.
Impact of maternity ward closures
Studies show that the closure of maternity wards decreases access to prenatal care, resulting in more complex pregnancies. According to the department of public health, LA county’s severe maternal morbidity rate has been increasing and is higher than the state average. With federal funding cuts straining hospital resources, healthcare workers and advocates fear these numbers could rise.
Maternity care deserts and cost-driven closures
Over 35% of US counties are considered maternity care deserts, and 537 hospitals nationwide lost their obstetric services between 2010 and 2022. High operating costs and declining birth rates contribute to these closures. Additionally, California is projected to have a shortage of obstetricians by 2030. California’s Medicaid, Medi-Cal, also has a reimbursement rate below the national average for obstetrics.
The disproportionate impact on women of color
Black women in LA county have the highest severe maternal morbidity rates, followed by Asian/Pacific Islander and Hispanic patients. Mashariki Kudumu, founder of the California Black Birth Equity Summit, attributes this to shortages in prenatal care providers in communities of color. State data shows that 64% of people seeking birthing care at an emergency room in LA county hospitals from 2016 to 2023 were Latino, 15% were Black, and 11% were white.
Alternate supports for maternity care
State senator Akilah Weber Pierson believes California must invest in maternal healthcare. Measures like expanding access to midwives and doulas could help bridge the gaps caused by maternity ward closures. Governor Gavin Newsom recently signed bills into law that expand midwifery training and streamline the licensing process for alternative birthing centers.
LA hospitals find unique solutions
Despite financial hardships, Martin Luther King Jr community hospital in south LA has increased its staffing and is building a team of midwives to address staffing concerns. The hospital opened a prenatal care clinic in 2023 to expand access to care throughout pregnancy. Laila Al-Marayati, an associate professor of clinical obstetrics and gynecology at the University of Southern California’s Keck School of Medicine, asks if society is willing to take an extra step to prevent the increase in maternal mortality rates due to lack of access to good care.
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