HOSPITAL’S LABOR AND DELIVERY TO CLOSE

Services for Poway will move to Palomar Medical Center Escondido in June

Doctors have been delivering babies at Poway’s only hospital since it opened in 1977, but that will no longer be the case in June as the facility’s parent company shifts labor and delivery services north to Palomar

Medical Center Escondido.

Diane Hansen, Palomar’s chief executive officer, confirmed in an interview that the move is in the works due to a persistently low volume of deliveries at Palomar Medical Center Poway, which was previously called Pomerado Hospital.

“We have maybe two deliveries at Poway per day, and yet we have to support nursing care and physician coverage 24/7,” Hansen said. “It just has become financially untenable.”

State records confirm the assertion that Poway’s volume of newborns has dwindled. Annual data submitted to the California Department of Health Care Access show that there were 796 babies born at the hospital in 2022 compared to 3,693 at Escondido. Poway, state data indicate, has not recorded more than 1,000 deliveries in a single year since 2018, when it reported 1,297.

Hansen said that efforts to recruit more obstetricians to deliver at Poway have been unsuccessful. Market research indicates many living in and around the hospital are instead giving birth at facilities such as Sharp Mary Birch Hospital for Women & Newborns in San Diego and Scripps Memorial Hospital Encinitas.

Palomar, she added, considers this more of a pause than a hard stop.

“I’m not willing to say that we’re never going to have OB services down at Poway again,” Hansen said. “I would love to see us at some point in the future re-establish an OB program down there, but it’s not going

to happen today or tomorrow; it might be several years down the road.”

In the near term, she added, Palomar intends to spend millions at Poway upgrading the hospital’s emergency and intensive care departments which have seen increases in patient volume.

Some are dismayed at the loss of birthing services in Poway.

Noah Friend said his wife gave birth there on March 10 and specifically selected the birthing center for its willingness to support women seeking a more natural path.

“When my daughter was born there, if it wasn’t for one of the labor and delivery nurses working with my wife for hours throughout the night, my daughter wouldn’t have been delivered naturally, as up to that point, a csection seemed like the only option,” Friend said.

The community, he predicted, will miss the approach taken at Poway.

“The culture of that hospital is unlike any other,” Friend said. “Considering that their labor and delivery has received awards, along with the glowing experiences of so many families, it’s an absolute shock that they’re being shut down.”

Dr. Omar Khawaja, Palomar’s chief medical officer, said the labor and delivery department has been studying other birthing centers, such as the “low-intervention birth” program at UC San Diego Health to inform changes at Escondido. While this can involve birthing in a water bath or with the assistance of certain equipment such as sitting on an inflatable ball during contractions to help gravity do its work, overall philosophy is also important.

“It’s less about the physicians and the nurses doing things to you and you being more in charge of your plan and your ideas and what you want it to look like,” Khawaja said.

The shift comes as Palomar has taken on additional labor and delivery work, starting to accept delivery referrals from community clinics in Oceanside in 2021 that are technically in the territory of the Tri-City Healthcare District. The referrals caused consternation at Tri-City and led to hearings before the San Diego Local Area Formation Commission, which ultimately affirmed an initial approval of the shift to Palomar.

State records indicate that Tri-City delivered only 552 infants in 2022 compared to 1,347 in 2021, when the change occurred. A Tri-City spokesman said in an email that the hospital’s governing board will address the situation at its next meeting on March 31.

Given the influx of patients from the west, some might wonder whether Palomar Medical Center Escondido has the capacity to absorb Poway’s volume. Executives said last week that they foresee no significant issues meeting demand in the hospital’s 18-bed postpartum unit, especially given that another significant change is in the offing.

Kaiser Permanente is scheduled to open its 206bed, $400 million hospital in San Marcos, less than three miles away, in August. About one-third of current delivery volume — approximately 100 deliveries per month — at Palomar Medical Center Escondido, executives said, are expected to flow to Kaiser San Marcos after it opens.

All medical personnel currently working in the Poway labor and delivery unit, executives said, are being offered positions at Palomar.