Watsonville Community Hospital’s maternity care is a regional responsibility – we can’t let it close

Have something to say? Lookout welcomes letters to the editor, within our policies, from readers. Guidelines here.

The closing words of the Pledge of Allegiance, “liberty and justice for all,” are resonating for us as we think about Watsonville Community Hospital (WCH). The choice facing its healthcare district is a difficult one: close labor and delivery or continue absorbing losses that threaten the hospital’s future.

Among the three of us, we have spent decades leading healthcare and public health efforts in Santa Cruz County, including through the COVID-19 pandemic. One of us helped lead the effort to return WCH to community ownership following bankruptcy and years of for-profit corporate management.

Recent discussion has focused on what the healthcare district has or has not accomplished since acquiring the hospital four short years ago. Not every decision has been perfect. But its leaders inherited enormous financial problems while rebuilding trust, stabilizing services and improving quality. 

WATSONVILLE COMMUNITY HOSPITAL: Read more Lookout news and Community Voices opinion coverage here

Now federal changes threaten healthcare coverage for many of the people it serves. And those people matter.

During COVID-19, many were called “essential workers.” They worked in healthcare, fields, packing sheds, kitchens and grocery stores, keeping our region and state functioning while much of the world shut down.

That same community came together when WCH faced bankruptcy because we understood something fundamental: People here needed a hospital.

WCH serves the Pajaro Valley, including northern Monterey County. Healthcare needs do not stop at county lines, and neither should our responsibility for ensuring access. Losing local maternity care would force families to travel sometimes an hour or more in traffic north or south. For someone experiencing an obstetric emergency, that distance can become a serious medical risk to mother and baby.

WCH faces an extraordinarily difficult choice: sustain labor and delivery at the risk of the hospital’s financial stability, or close an essential service for a community that needs it. The Pajaro Valley Health Care District governing board is scheduled to vote Wednesday at 5 p.m. on whether to close Watsonville Community Hospital’s labor and delivery services and neonatal intensive care unit (NICU).

That is the wrong choice for them to face alone.

Labor and delivery requires specialized staff available around the clock. At WCH, where Medi-Cal covers close to 85% of patients, the economics do not work. The hospital reports losing approximately $27,000 a day providing labor and delivery and related services.

Medi-Cal pays for deliveries. But reimbursement doesn’t adequately recognize the cost of maintaining maternity care around the clock, regardless of how many babies are born.

In 2024, WCH delivered 748 babies — about 30% of births reflected in Santa Cruz County’s delivery-location data, more than either Dominican or Sutter individually. 

If Watsonville’s labor and delivery unit closes, the births do not disappear. Patients and associated costs shift elsewhere — to other hospitals, emergency transportation systems and families who must travel farther for care, regardless of access to reliable transportation. Receiving hospitals might gain patients and revenue, but the region loses maternity capacity where it is most needed.

The question should not be whether WCH alone can afford to keep labor and delivery open; we know the answer. The answer is not to pass along the burden to others. 

The better question is: If maternity care is essential to this community, how do we make it sustainable? And what partners do we need to do that?

Regional responsibility should begin before patients are displaced, not after.

Our regional healthcare partners have different resources and responsibilities. Together, they have options no single organization has: shared physician coverage, recruitment and clinical staffing; improved access for commercially insured patients; contracting changes; enhanced payments recognizing the cost of maintaining maternity services; and other partnerships.

The right solutions must follow the evidence and be developed together.

WCH, Kaiser Permanente, Sutter Health, Dignity Health, Central California Alliance for Health, community providers and public partners from Santa Cruz and Monterey counties need to act now for a sustainable plan. California’s Department of Health Care Services also has an important role in exploring financing options.

This cannot be just another discussion. It must produce concrete options, commitments and a timeline.

The emerging UC Santa Cruz–UC Davis medical education partnership also offers an opportunity to strengthen the region’s healthcare workforce. Preserving maternity care at WCH could create future opportunities for clinical training and help to attract and retain physicians serving Central Coast families.

The problem extends far beyond Watsonville. 

The Journal of the American Medical Association published a national study in December 2024 showing that 537 U.S. hospitals stopped providing obstetric care between 2010 and 2022 – 299 urban and 238 rural. When maternity units close, families travel farther, emergency care can be delayed, and mothers and babies face greater risks. For babies, that risk can result in lifelong disability. And when communities lose labor and delivery capacity, it is extraordinarily costly and difficult to rebuild.

California needs a longer-term solution. 

State law recognizes perinatal care, including delivery services, as essential to maternal and infant health, a finding reaffirmed in the legislative analysis of Senate Bill 669, which is specifically designed to help rural hospitals maintain emergency maternity care even when they cannot sustain a full labor-and-delivery unit. SB 669 takes a step toward addressing access through a pilot allowing certain critical access hospitals to provide standby perinatal services. 

The state should go further – require state approval rather than just notice for essential maternity services to close. 

It should use this process to determine what the necessary regional maternity capacity is and identify appropriate ways for healthcare partners and government to share responsibility for sustaining it where it’s needed most. Watsonville could demonstrate how essential services can be preserved where community need is clear but the economics do not work.

And Watsonville cannot wait for a statewide solution.

Four years ago, this community decided WCH was too important to lose simply because its economics no longer worked for its owner. Public and private partners stepped forward. Organizations that normally competed worked together. The community refused to accept closure as inevitable.

We face a version of that question again. With 816 births in 2025, the need for maternity care in the Pajaro Valley is clear. Even if the board votes to initiate closure, there are still 120 days to change that outcome. The question is whether our regional partners will share responsibility for keeping it here.

We called the people of this community essential. Their healthcare should be treated that way, too. 

Liberty and justice for all has to mean something.

Dr. Gail Newel is a former Santa Cruz County health officer and an obstetrician-gynecologist. 

Dr. David Ghilarducci is a former Santa Cruz County health officer and an emergency medical services specialist. 

Dori Rose Inda is the former CEO of Salud Para La Gente and helped lead efforts to return Watsonville Community Hospital to community ownership. 

All three have served in healthcare leadership roles in Santa Cruz County.