Tulare County’s expectant mothers have one less place to receive maternity care as of Thursday.

A drop in Tulare County’s birth rate and the number of planned births at Adventist Health Tulare led the decision to close the maternity ward, a hospital official said.

That means closing labor and delivery, maternity care, and other obstetrics services. The hospital will still provide births through the emergency department.

After the close, mothers wanting to deliver their baby in a hospital will have to go to Visalia, Reedley, or Hanford. Adventist hopes to be able to reopen again through local partnerships with health advocacy groups and clinics, said Kiyoshi Tomono, partnership and well-being executive at Adventist Health Central California Network.

But closing the department follows a trend in California of maternity wards shutting down because of lack of demand.

“Hospital births have declined by 60 percent over the past year at Adventist Health Tulare and the hospital can no longer sustain these services,” said Tomono. “This decline in births at Adventist Health Tulare aligns with a significant drop in the birth rate in Tulare County and a significant decrease in births in California.”

More Tulare Mothers Relying on Emergency Department

After the hospital closed in 2017, OBGYNs got in the habit of not sending their patients to then-Tulare Regional Medical Center, said Heather Van Housen, patient care executive for the Central California Network of Adventist Health.

Births at the hospital came nearly all from mothers going into the emergency department, which Van Housen said is less safe than having a planned birth.

In 2022, the hospital provided services for 20 births. By 2024, that number decreased to eight.

“If you want to do things and do things well, you need to do more than five a month, said Van Housen, who added that the ideal number was closer to 50.

The hospital network explored a partnership with health care clinic Altura Centers for Health to work with OBGYN doctors in connecting them and their patients with Adventist Health. Tomono said reviews done on the two doctors — one in 2022 and one in 2023 — determined they did not meet the hospital’s criteria. The hospital is reviewing that decision, Tomono said.

“We are committed to working diligently to resume obstetrics services in Tulare in the future,” Tomono said.

Maternity Wards Closing All Over California

Tulare is hardly the only hospital to close its maternity ward. Matthew Beehler, chief strategy officer with American Advanced Management, the health system taking over operations for Madera Community Hospital, said the company is holding off opening the maternity ward at that hospital because of few planned births.

In the past decade, nearly 50 California hospitals have closed maternity wards, CalMatters reported. Half of those closings came in the last four years.

The trend follows in Florida where the state’s Legislature this year enacted a law allowing doctors to deliver babies via cesarean section outside of hospitals, according to the Kaiser Family Foundation.

The idea was to lower costs and give pregnant women a “homier birthing atmosphere.”