Mendocino Coast District Hospital Special Meeting Nov 8 2019




10:00 AM





Our hospital district heads appear to have surgically removed Labor and Delivery (L&D) services not only from the community conversations about affiliation, but from the negotiations with AdventHealth Corporation. Three years ago, our district board and CEO threatened to close this department due to large losses. There was a huge public meeting in Cotton Auditorium. Many of you will remember the several hour impassioned public testimony in support of keeping Labor & Delivery an essential service here. It made a difference. And hundreds of babies have been born here since then because of you. In spite of the enormous efforts by many of us over the last 3 years to assist our public hospital, looking into ways to diminish those losses and increase revenues, we were mostly thwarted in our efforts by those with more power who have had their minds made up from the beginning. They continue to create a false narrative equating keeping L&D with losing the hospital. They insist that the core issue of childbirth in Fort Bragg is a financial one. With a black and white solution. I insist that this is a social, moral and ethical issue. Do we really value new life and the life of mothers so little that we will sacrifice them to this type of discrimination at their most vulnerable? Is the most fundamental human health event not worthy of more respect?
Will we continue to be blind to the socio/economic realities of discouraging young people to stay or move here to be part of our community? If we have such a graying population, don’t we want to encourage young people to live here to take jobs to keep the economy going and take care of us?
There are many repercussions to closing this service that are not being discussed, that will have a serious impact on the overall financial, healthcare and social networks for women, children, families and our community. Where these L&D closures happen, rural communities lose young people and suffer because of that. Eventually many hospitals close as well due to the resulting low volumes. Plumas Health in Quincy, a hospital like ours but with fewer births, committed to a full OB/GYN service and have 3 permanent doctors. It can be done. Certainly there are financial concerns with our independent public hospital due to many factors. Not just OB. Almost no hospital OB breaks even, regardless of high birth rates. This is about values. Many who believe that L&D must remain available here if we are to remain a viable community, worked extremely hard to pass our Measure C Parcel Tax. We were successful, largely because we believed these funds would offset some of the losses in OB and help our hospital in many other ways. That has proven to be true. Now we are being sold down the river by their desire to close L&D before an affiliation vote instead of advocating for it. I am not opposed to a robust agreement with AdventHealth if it specifically includes maintaining L&D. They can and will do it. IF the community insists. They do want our hospital. We actually have a lot to offer them. Depending on the “out clauses” agreed to, they don’t necessarily have a long term commitment to our coastal community. But once we vote for affiliation, we will have no more voice. Nov 7 is the time to speak up and insist that our district board advocate to keep L&D now and in negotiations. There are many stories going around about ideas to mitigate the problems that will be encountered without L&D. But they are just stories.
There is no plan. There is no evidence or assurance the ideas will even happen, be effective or would promise no negative outcomes. Families will suffer. I would not be writing this letter if I, a young healthy low risk pregnant woman, had not been within 20 minutes of a hospital for an
emergency CSection. My dear son would not have lived and his younger sister would never have been born. Our neighbors and loved ones are not just statistics. This is real. I do not want the death or injury of the first or future mothers and babies on my conscience because they could not make it to Ukiah in time. Do you?

Carole White
MCDH Planning Committee member, MCDH Patient and Family Advisory Council Launch Committee, MCDH, Hospice Volunteer, MCDH OB Ad Hoc Committee member, Measure C Campaign Committee
PO Box 108, Fort Bragg


  1. I was a participant in that discussion at Cotton Auditorium and I was responsible for gathering all the historical and current financial data surrounding the Labor & Delivery department.

    Everyone from the community that spoke at that forum did so with passionate emotions. And they were all in favor of keeping the L&D service at MCDH. Passionate emotions go a long way in stirring up controversy and an even longer way in losing sight of the true issue. But I have yet to see passionate emotions foot the bill for a service that loses millions of dollars without any hope of ever breaking even.

    What would the bottom line of your business look like if you were shamed into continuing to operate at a loss? It’s a business decision not an emotional decision. We all want a local hospital with every type of medical service available but this community cannot sustain it. Too bad the ones in Administration and on the Board of Directors at MCDH in 2016 couldn’t have made the tough but life-saving decision necessary back then. MCDH’s financial status might not be as critically low as it is today.

  2. I am concerned about the fact that the discussion about labor and delivery has become very polarized. Instead of yes/no arguments I think that we should be thinking of alternative ways to provide those services. Here are a couple of ideas I’ve heard about being employed elsewhere: In one hospital the whole emergency room staff is cross trained to handle obstetrical emergencies. There would still be labor and delivery services, but there would be no need for full time physician staffing. Many variants of this could be worked out. At another hospital the labor and delivery nurses also served as floor nurses when not involved in a birth, thus cutting staffing needs. The two could be combined. These are just some ideas to avoid the very dangerous bifurcation that seems to be going on. I would invite people to think ‘out of the box’ Both sides of the argument need to acknowledge and work to mitigate the concerns of the other side. Thank you for your consideration.

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