Rural Hospitals Are Shuttering Their Maternity Units

“They are poor in spite of working hard,” said Dr. Jordann Loehr, an obstetrician who works at the Yakima Valley Farm Workers Clinic.

Many women opted to give birth at Astria Toppenish because of its reputation for respecting patients’ wishes and for cultural sensitivity — including a labor room for Native American women that faces east, an ancestral practice, and permission for as many family friends and “aunties” in the delivery room as the mother wanted.

The nurses did not rush women in labor, and the unit had a cesarean section rate of 17 percent (way below the national average of 32 percent.) They taught first-time mothers about infant care and breastfeeding — but also about how to use a papoose board safely, and why mothers shouldn’t overbundle a newborn, a common practice.

Nurses at the hospital introduced new mothers to ideas that contravened long-held beliefs.

“Our population generally has the cultural understanding that you don’t hold newborns — it makes them needy,” said Angi Scott, a labor and delivery nurse. “We tell them, ‘No, you can’t spoil a newborn. Babies who are held more in the first year of life grow up to be more self-assured. It’s important to hold your baby.’”

Many residents fear the obstetrics closure is a prelude to the hospital closing its doors altogether in a repeat of what happened in 2019, when the Astria Health system declared bankruptcy and later closed the largest of its three hospitals, a 150-bed facility in Yakima. Astria had purchased the hospital just two years earlier.

For now, the four obstetricians in town — all women — are digging in. Dr. Loehr has led a community drive to reestablish a maternity unit by creating a public hospital district, a special entity that would be governed and funded locally with taxes or levies.

Dr. Anita Showalter, another obstetrician, recently delivered Ms. Barajas’s baby, but at an Astria hospital farther away. She already had suffered one miscarriage, and Dr. Showalter stayed with her through 37 hours of labor. Baby Dylan was born on Jan. 15 at 1:52 a.m. “My heart is full,” Ms. Barajas said in a text.