• 53 workers will be laid off; some may be relocated.
• The hospital’s births have dropped nearly 25%.
• The closure is part of a growing trend for birthing units across the state.
• 5 Ventura County hospitals still have labor and delivery units.

The May 8 closure of a hospital labor and delivery unit won’t turn Simi Valley into a maternity care desert but the terrain will become drier, some observers predict.

Leaders of Adventist Health Simi Valley said in February they will join the list of nearly four dozen California hospitals that have shut down birthing units since 2012. In addition to the eight-bed maternity department, they will also close an eight-bed intensive care for newborns.

The hospital has told state officials 53 employees will be laid off because of the closures but said some of those workers could be relocated.

In a statement released Thursday, hospital leaders said they are working to minimize the impact of the closure. Some observers note the nearest hospital with a birthing center is Los Robles Regional Medical Center in Thousand Oaks, nearly 17 miles from the Simi hospital.

“We are aware of the planned closure, and we are paying very close attention,” said David Pisani, director of advocacy and government affairs for March of Dimes in California. “That 17 miles can put a woman and the baby she is about to deliver at great risk.”

Why is it closing?

Hospital leaders said the move is driven by a birth rate that has fallen nearly 25% in recent years. In 2017, 598 babies were born at the hospital. In 2023, the number fell to 455 — a level hospital leaders said they cannot sustain.

The hospital’s birth rate is in sync with state and countywide trends. It also reflects an aging Simi Valley population where the median age has climbed to just over 41 years of age.

“Our demographics are changing. We continue to see more stroke and heart attacks,” said hospital spokesperson Alicia Gonzalez. “The hospital wants to make sure we are ready to serve the needs of our aging community.”

What other maternity wards have closed?

Of the at least 46 hospitals that have closed birthing units, 11 closed last year, according to the nonprofit news site CalMatters. Contributing factors include birth rates, workforce shortages, low Medi-Cal reimbursements for births and the struggle of hospitals to stay out of debt.

Money is “probably the primary driver,” said Paul Young, a senior vice president for the Hospital Association of Southern California, also citing growing shortages of OB-GYN doctors and anesthesiologists. “It’s tough to provide a service if you don’t have the workforce to do it.”

Some of the closures have hit nearby hospitals. Dignity Health in 2012 closed the maternity unit at its Camarillo site, now called St. John’s Hospital Camarillo. Births stopped in 2020 at a West Hills hospital then owned by HCA Health Care and now operated by UCLA.

A birthing unit at Santa Paula Hospital closed briefly and reopened in 2019. Concerns remain about the volume of births at the hospital, said Dr. Frederick Kelley, director of obstetrics and gynecology at Ventura County Medical Center and Santa Paula Hospital.

What are the fears?

Across Ventura County, five hospitals will continue to operate labor and delivery units, including Los Robles, St. John’s Regional Medical Center in Oxnard, Ventura County Medical Center in Ventura, Santa Paula Hospital and Community Memorial Hospital – Ventura.

“I think we’re OK in Ventura County,” Kelley said. “No one’s too far from a hospital.”

Others said the chances of complications and roadside births rise with every closure. Pisani cited scenarios in which a woman’s water breaks during the journey from Simi Valley or she is stuck in traffic. Others worry too about dwindling choices for pregnant women.

“Any time an option for labor and women closes, it’s really a shame,” said Rachel Marriott, midwife and owner of the Simi Valley Birth Center.

What’s being done?

In a statement, hospital leaders said they are working with doctors and other hospitals to make sure the transition is safe and efficient. The group of doctors that perform many of the births at Adventist Health Simi Valley, Simi Obstetrics & Gynecology Group, announced on its website the doctors will do all their deliveries at Los Robles in Thousand Oaks.

People experiencing emergency births will still have the option of going to the emergency room in Simi Valley.

Maternity care deserts are communities where there are neither birthing units nor obstetrician-gynecologists. Neither Simi Valley nor Ventura County meet the definition. But access to care could suffer, observers said.

Marriott said access issues already exist at the hospital. Few of the OB-GYNs who accept Medi-Cal deliver babies at the hospital, meaning many low-income people covered by the government insurance program have to go elsewhere.

It’s a huge population. About 40% of the 420,000 births across California were covered by Medi-Cal in 2021, according to a study by the California HealthCare Foundation.

“This just made it worse,” Marriott said of the birthing unit closure. “Now, we have even more people unable to access care in their own community.”

Who will lose jobs?

The layoffs include 10 lead nurses, two nurses in an Adventist Health residency program, 34 additional registered nurses, six obstetric technicians and one lead obstetric technician, according to a letter submitted by the hospital to the California Employment Development Department. Gonzalez, the hospital spokesperson, said the hospital continues to work with affected employees in finding jobs within Adventist Health.

The coming closures have generated debates across Simi Valley, both in and outside of the hospital.

Laura Malinowski is executive director of Sarah’s House nonprofit maternity home program for the homeless. Many of her clients are covered by Medi-Cal and already have to drive to Ventura to give birth. Still, she has heard praise for the Simi hospital’s labor and delivery program.

She also understands the reasons for its closure.

“We’re getting older and younger families can’t afford to live here,” she said.

Tom Kisken covers health care and other news for the Ventura County Star. Reach him at [email protected].

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