![\"Abbie](\"https:\/\/www.newsbeep.com\/il\/wp-content\/uploads\/2025\/12\/ZBRUYTNGHBFE5OPVFYMNZBBU4I.jpg\")
<\/p>\nOn a recent afternoon in Seaside, Oregon, Heather Murdoch-Medema packed up her apartment, categorizing which boxes would go into storage and which she would take with her to her new home in Portland.<\/p>\n
Murdoch-Medema has worked as a labor and delivery nurse at Providence Hospital in Seaside since 2023. She moved for the job and fell in love with the small town of just around 7,000 people.<\/p>\n
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Abbie Reed and her daughter, Clara at Reed’s home in Wheeler, Ore. on Oct. 22, 2025.<\/p>\n
Rachel Miller-Howar \/ Northwest News Network<\/p>\n
\u201cEverywhere I went, if I talked with someone and something came up like, \u2018oh, I\u2019m new to Seaside,\u2019 they were like, \u2018well, welcome. We\u2019re so glad you\u2019re here,\u2019\u201d she said.<\/p>\n
The job didn\u2019t last as long as she had hoped. Providence Seaside decided to close its obstetrics unit in August, and Murdoch-Medema accepted another position in Portland. The clinic shuttered Oct. 3.<\/p>\n
She now worries for her patients. She said some people she saw didn\u2019t have transportation, and would walk to the hospital in the rain for their prenatal appointments.<\/p>\n
\u201c\u200aWe\u2019re just gonna close these hospitals, and then we\u2019re gonna see more moms in trouble. A mom trying to get to the hospital that she needs to be at, she can\u2019t get there,\u201d she said. \u201cI think that \u2026 in some situations, will either cost the life of the baby or mom, or of both.\u201d<\/p>\n
![\"Heather](\"https:\/\/www.newsbeep.com\/il\/wp-content\/uploads\/2025\/12\/AMRR37L3ORBYJNSER675RCGG7E.jpg\")
<\/p>\n
Heather Murdoch-Medema packs up her apartment in Seaside, Ore. on Oct. 30, 2025.<\/p>\n
Rachel Miller-Howard \/ Northwest News Network<\/p>\n
Hospitals struggle to keep obstetrics units open <\/p>\n
The closure is far from unique. Six rural hospitals in Oregon and Washington have closed their obstetrics units since 2020, according to the Center for Healthcare Quality and Payment Reform.<\/p>\n
Kristine Bell, executive director for Providence Women and Children\u2019s Services in Oregon, said the decision to close the unit at Seaside Providence was based on several factors.<\/p>\n
At its peak in 2015, Seaside Providence was delivering around 120 babies a year. In 2024, that number had dropped to 66 babies a year.<\/p>\n
The birthrate in the Pacific Northwest is declining. In Oregon, it fell by around 22% <\/a>between 2013 and 2023, and in Washington it fell by around 18%<\/a>, according to data from the non-profit advocacy organization March of Dimes.<\/p>\n On top of that, Bell said Seaside was seeing more births with older, first-time moms who are at higher risk for complications, reflecting a regionwide trend.<\/p>\n In Oregon and Washington, the majority of people who gave birth were 30-years-old or older between 2021-2023<\/a>. Ten years ago, the majority were under 30-years-old<\/a>.<\/p>\n \u201cWhat we see is there are fewer and fewer of what we would consider a healthy low-risk pregnancy, and so that requires a little bit more infrastructure,\u201d she said.<\/p>\n Recruiting staff was also a challenge. The hospital had tried to recruit an obstetrician for nearly two years, but did not get any candidates. The obstetrics unit was also losing a significant amount of money. Bell said 65% of their patients were on Medicaid, which did not fully cover the cost of their care.<\/p>\n Ashley Stoneburner, director of applied research and analytics at March of Dimes, said these are all common reasons for rural labor and delivery unit closures, and it\u2019s making delivery riskier.<\/p>\n \u201c\u200aWe know that if you live far from your provider during pregnancy … you may not make your appointments for your prenatal care, which puts you at risk for poor birth outcomes,\u201d she said.<\/p>\n Bell said patients can still get prenatal care at Seaside, but they need to find another option for delivery.<\/p>\n Expecting parents on the Oregon coast consider other options<\/p>\n For Seaside resident Taylor Dyer, the closure of the obstetrics ward felt like a breach of trust. She was born at the hospital and gave birth to her first child there.<\/p>\n She and her husband have been considering having a second child, and she\u2019d expected to be able to give birth at Seaside.<\/p>\n \u201c\u200aI started crying, you know, because you kind of depend on that consistency when you get pregnant,\u201d she said.<\/p>\n If she decides to have another baby, she\u2019ll need to choose somewhere else to give birth.<\/p>\n Those who are currently pregnant have to make that decision in real time. Abbie Reed lives about 30 minutes south of Seaside in Wheeler, Oregon and is due Feb.1. She gave birth to her first daughter at Seaside in 2024. She wanted a vaginal birth with no epidural, and the hospital respected her wishes, but there were complications.<\/p>\n \u200a\u201cI hemorrhaged, so I lost a lot of blood. So that definitely was a not ideal situation,\u201d she said.<\/p>\n She said she was happy with Seaside\u2019s care during a very difficult situation. She trusted the hospital to help her with her second birth and was devastated when she found out it wasn\u2019t an option.<\/p>\n \u201c\u200aI was super blindsided. I was like, can they, can they do that? Like can a hospital do that?\u201d<\/p>\n For her next birth, she decided on The Astoria Birth Center. The center serves patients they consider to be low-risk and who do not want an epidural or cesarean. It is staffed by midwives. It\u2019s a longer drive to get there than it would be to drive south to Tillamook, but with Seaside out of consideration, it was the option Reed preferred.<\/p>\n Clinics in Astoria have the capacity to absorb Seaside\u2019s patients, and then some<\/p>\n The Astoria Birth Center serves families from northwest Oregon and southwest Washington.<\/p>\n Rebeckah Orton, executive director of the Astoria Birth Center, said the center can handle 15 births a month, but they are nowhere near that.<\/p>\n \u201c\u200aWe could comfortably absorb the entire clientele that Providence was seeing,\u201d she said.<\/p>\n Half a mile down the road is Columbia Memorial Hospital. Medical Director of OBGYN services Dr. Sarah Humphrey said she\u2019s familiar with the challenges of practicing medicine in rural communities.<\/p>\n \u201cWe had a power outage once and I did a pap smear with a headlight,\u201d she said.<\/p>\n When it comes to absorbing Seaside patients, she said the hospital would rise to the occasion. Columbia Memorial has also seen a dip in labor and delivery patients in recent years.<\/p>\n \u201c\u200aWe used to deliver around 350 a year. And then COVID had a big decrease in births in general. And with the opening of the Astoria Birth Center, they took some of our low risk labor,\u201d she said. \u201cSo we\u2019re currently around 270 a year, but we definitely have the capacity to go up.\u201d<\/p>\n Rebeckah Orton, executive director of the Astoria Birthing Center sits for a portrait at the center on Oct. 24, 2025.<\/p>\n Rachel Miller-Howard \/ Northwest News Network<\/p>\n Rural labor and delivery care is caught in a vicious cycle. Birth rates are declining, staffing small units in small places is challenging, and the care is expensive. Births can happen at any time, and labor and delivery units need to be staffed 24 hours, even if there aren\u2019t very many patients.<\/p>\n Ashley Stoneburner, with March of Dimes, said the future of maternal healthcare is precarious nationwide.<\/p>\n \u201c\u200aOver a two-year period, we saw over a hundred hospitals close. We know that because of the cuts that are impending for Medicaid, that we will probably see a lot of hospitals close their labor and delivery units in the next few years. Which is really, really concerning because that\u2019s gonna mostly be felt in the rural areas,\u201d she said.<\/p>\n What\u2019s next for Seaside and other rural communities?<\/p>\n Stoneburner said even with the closure, Seaside residents still have better access to maternal health services than many rural areas in the country.<\/p>\n \u201cIn the United States, over 35% of counties are considered maternity care deserts, and that\u2019s home to over 2.3 million women of reproductive age,\u201d she said. \u201c\u200aIf there\u2019s another hospital that can deliver babies within the county, then it\u2019s not technically a maternity care desert,\u201d she said.<\/p>\n She said there is no standard for how close you should live to a hospital when you are pregnant or during delivery, but there is some research on how soon you should be seen during an emergency.<\/p>\n \u201cWe do have other examples, like if you have an emergency C-section \u2026 it\u2019s called the decision to incision time,\u201d she said. \u201cThat means that once they make the decision you need an emergency C-section, the baby should be out in 30 minutes.\u201d<\/p>\n She said that after a hospital closes its labor and delivery unit, patients will still come to the emergency department if they need care.<\/p>\n \u201cThere\u2019s not necessarily the obstetric clinicians that can deal with emergency situations, but people still present in the emergency room, which is concerning. However, there\u2019s a lot of efforts to train those providers to deliver obstetric care. So in that instance, they could take care of the mom and baby,\u201d she said.<\/p>\n Seaside Providence said it is prepared to accept obstetrics patients in its emergency department.<\/p>\n When asked about the types of obstetric emergencies the ER could handle and whether providers were prepared to do an emergency cesarean, Kristine Bell, executive director for Providence Women and Children\u2019s Services in Oregon, said that each situation is nuanced, but that the hospital would stabilize the patient.<\/p>\n \u201cStabilizing a pregnant woman in an emergency department without obstetric services involves an immediate medical screening, stabilization of her condition using the hospital\u2019s capabilities, and transfer to an appropriate facility if necessary,\u201d she said.<\/p>\n Dr. Sarah Humphrey at Columbia Memorial Hospital in Astoria said she is working with Seaside Providence to help coordinate transferring patients when needed.<\/p>\n She\u2019s also holding training sessions with first responders to ensure they are prepared should patients need help on the way to the hospital.<\/p>\n \u201cIt wouldn\u2019t be the first time that someone\u2019s delivered in their car, or in an ambulance,\u201d she said.<\/p>\n Abbie Reed, the pregnant woman in Wheeler, said she\u2019s not worried about giving birth in the car on her hour-long drive to Astoria.<\/p>\n \u201cMy husband and I, we\u2019re Christians. We believe in God. And so I feel like in those types of moments, we just surrender it and we trust that it\u2019d be okay.\u201d<\/p>\n![\"Rebeckah](\"https:\/\/www.newsbeep.com\/il\/wp-content\/uploads\/2025\/12\/PC525SKDB5FHZLMKHUOWY2VKBA.jpg\")
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