In the face of rapidly disappearing maternity care, Gov. Gavin Newsom this weekend vetoed a bill that was meant to slow closures of labor wards but signed a law that will give communities more time to plan for the loss of that service.
At least 56 maternity wards have closed across California since 2012, according to CalMatters’ reporting. The closures have happened in both rural and urban areas, resulting in long drive times for patients and overwhelmed obstetrics departments in neighboring communities. At the same time, rates of maternal mortality and complications are increasing.
The new law, Senate Bill 1300, authored by Sen. Dave Cortese, a Democrat from Campbell, requires hospitals to notify county government 120 days before closing a labor and delivery or psychiatric unit. The notification would also include a public hearing.
Hospitals are currently required to provide notice 90 days before an impending closure. The idea behind increasing that window, Cortese said, is to create a more transparent process and give communities ample notice.
“By requiring private hospital corporations to disclose such information, public health and hospital systems will be better informed and equipped to absorb the loss of services by private providers. This in turn, ensures patients don’t lose out on potentially life-saving medical care services,” Cortese said in a statement prior to Newsom’s signature.
Newsom vetoed a second bill, Assembly Bill 1895, authored by Democratic Assemblymember Akilah Weber of La Mesa, that would have required hospitals to notify the state if they are at risk of losing maternity services. It would have required hospitals to report staffing and financial information to the state, and the state would have been required to assess how a potential closure would affect the surrounding community.
In his veto message, Newsom said that some of the information the bill required hospitals to report to the state was duplicative to what they already have to provide, and that the bill would have added costly administrative requirements for the state that are unlikely to change a hospital’s business decisions. Instead, Newsom pointed to a recent $300 million loan program approved last year that gave bailout loans to 17 financially distressed hospitals as an example of an effort to sustain medical services.
Weber, an obstetrician from La Mesa, had said she hoped the legislation would give the state the opportunity to avert closures. A major obstacle that state regulators and lawmakers currently face, Weber said, is that they typically find out about hospital service cuts at the same time as the public.
“The community is looking at us asking ‘What can you do as a state?’ It’s really hard to jump into that conversation so late in the game,” Weber said prior to the veto. “This is one way the state can act as a partner.”
Neither proposal would have required the state to stop a potential maternity ward closure, but the early warnings could allow lawmakers to consider rescue interventions like emergency loans or programs to bolster the workforce.
Hospital administrators say high costs, labor shortages and declining birth rates are fueling the closures. Births have dropped to the lowest level on record over the past thirty years, but health advocates and clinicians say that doesn’t make access a non-issue. Most of the state’s population lives within 30 minutes of a birthing hospital, but 12 counties do not have hospitals delivering babies.
The new law comes as California health officials move to reduce pregnancy-related deaths. Between 2019 and 2021, 226 patients died while pregnant, during labor or shortly after giving birth, according to data from the California Department of Public Health.
Recently, the state Surgeon General Dr. Diana E. Ramos unveiled an educational campaign for patients and providers about the factors that contribute to pregnancy-related deaths. State data shows the majority of maternal deaths in California are caused by heart disease, hemorrhage and sepsis or other infections.
Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.
Kristen Hwang, Ana B. Ibarra and Erica Yee are reporters with CalMatters.
