Scripps Health will move forward Sunday with its plans to end scheduled deliveries at its hospital in Chula Vista, a move that some in the community have said could be problematic for mothers with fewer resources and for those who experience medical emergencies while pregnant.
The San Diego health system announced its plans for labor and delivery at Scripps Mercy Hospital Chula Vista in early March, notifying the public and the estimated 135 employees directly affected that it would shift the department north to Scripps Mercy Hospital San Diego.
The unit, with a maximum capacity of 30 beds, in Chula Vista, which includes both delivery and recovery rooms, would be repurposed into an adult ward that serves patients who need short-term observation and diagnosis after arriving in the hospital’s busy emergency department.
It is a plan that drew the immediate ire of the labor and delivery community in south San Diego County, with several physicians saying they worry that many patients would still arrive at Mercy Chula Vista. Concerns are greatest for those with the fewest resources, especially mothers who rely on public transportation.
Similar concerns have been expressed nationwide as many smaller hospitals eliminate maternity services. Locally, Tri-City Medical Center in Oceanside, Paradise Valley Hospital in National City and Palomar Health Medical Center Poway have all taken similar steps.
Scripps calls the change at Mercy Chula Vista a consolidation, moving personnel 12 miles north to Mercy San Diego. It’s a similar move to the one undertaken by Palomar in 2023 when the inland North County provider consolidated its labor and delivery operations at its main hospital in Escondido.
Emergencies, especially those particular to pregnant women such as placental abruption, a potentially deadly condition that causes heavy bleeding, must be handled quickly and with skill, and some have worried that, without its own labor and delivery department, Mercy Chula Vista could struggle to handle such cases.
Concerns were strong enough — generating local protests — that a local obstetrician asked the state health department to investigate the situation, but that request was quickly rejected, allowing closure plans to proceed.
Dr. Latisa Carson, a South Bay obstetrician and gynecologist in private practice who delivered babies at Scripps Mercy in the past, has been a vocal opponent of the closure. She said this pastweek that many are skeptical about the effectiveness of the medical provider’s plans, both for moving deliveries made by an existing medical residency program from Chula Vista to Hillcrest and for handling pregnant emergency patients after the Chula Vista labor and delivery unit closes Sunday.
She said that a Scripps flyer circulated among Mercy Chula Vista emergency personnel which lists seven numbered steps for “emergency delivery” has caused some consternation among the local obstetrics community.
“It’s really quite scary,” Carson said. “We’ve heard that they had the ER doctors go up to Scripps La Jolla for three or four hours of OB training as if, you know, obstetrics is some type of hobby.”
But Debra McQuillen, Scripps’ chief operations executive, said this week that many steps have been taken to safely serve pregnant emergency patients once the labor and delivery unit closes and deliveries are no longer scheduled at Mercy Chula Vista.
The most fundamental step in preparation for the change, she said, has been notifying first responders and other social service organizations that, starting 7 p.m. Sunday, pregnant patients should not be taken to Scripps Chula Vista for deliveries unless their health condition makes their arrival in the hospital’s emergency department unavoidable.
“We’ve really tried to put the word that we will not have those services here throughout the EMS community, including the Border Patrol and all of our community clinics and with many community agencies that deal not just in health care but (also) that deal in social services for patients,” McQuillen said.
Though first responders should get the message, it is still common medical practice to transport severely injured patients to the closest hospital, so pregnant women in immediately life-threatening situations may still end up going to Mercy Chula Vista. And others may choose to go there of their own volition without using the formal emergency medical transport system.
For those, McQuillen said, Scripps has worked to strengthen the skills of emergency personnel, consulting with other hospitals that have closed labor and delivery departments in the past.
“We’ve had our emergency department physicians and emergency department nurses go through specialized neonatal and maternal training,” McQuillen said. “We also have a labor and delivery nurse who will be embedded 24/7 in the (emergency department) for this transition period.”
A panel of obstetricians, she added, will be available to consult with emergency docs in cases where emergency cases involving pregnant patients occur and they feel uncomfortable making decisions on their own. And, she added, several rooms in the Mercy Chula Vista emergency department will retain the specialty equipment, such as baby warmers, that are needed for deliveries.
“We’ve designated rooms in the emergency department, and our staff have been trained to use the equipment needed in an emergent delivery,” McQuillen said.
The standard protocol for these situations, she added, is to stabilize mother and baby and then transport the pair to Hillcrest, or to the nearest hospital with a maternity unit, when doctors deem it medically appropriate to do so. Employees and other observers recently noticed that Scripps has recently landed medical transport helicopters in Mercy Chula Vista’s parking lot, speculating that this is to address criticism that it may take too long, especially during periods of heavy traffic, to transport women for delivery at Hillcrest.
McQuillen said there is a desire to add a helipad at Scripps Chua Vista, but those plans are not entirely predicated on maternity patients alone. Scripps, she said, plans to increase the amount of cardiac care it offers at its Chula Vista hospital, and some of those patients can be expected to need more advanced treatment available only at larger hospitals to the north.
Ground transport, she added, would be by regular ambulance if a newborn is in good health. But those needing a stay in the neonatal intensive care unit at Scripps Mercy San Diego would go by specialized ground transport run by Rady Children’s Hospital.
San Ysidro Health Center said several months ago that it was collaborating with other nearby hospitals, including Sharp Chula Vista Medical Center, to have its obstetricians, who have customarily delivered at Mercy Chula Vista, find other locations.
The federally qualified health center did not elaborate on those plans this past week, indicating that its top executive was out of town and unable to comment.
Scott Evans, Sharp’s senior vice president and market chief executive officer, said that Sharp Chula Vista has recently received “many applications from San Ysidro health medical staff for privileges” to deliver babies at the facility. And a special web page — sharp.com/southbaymaternity — for South Bay families has also been added.
“We continue to have capacity to manage the expected increase in maternity volume,” Evans said.
