Upheaval in pregnancy care leaves patients unsettled

Emily Little sat on the nursery floor next to her 10-month-old son as he crawled between a rocking horse and a rainbow xylophone.

When he began to cry softly, she picked him up and wrapped him against her chest in a sling — a moment of closeness she describes as one of the most important of their lives. 

As a mother and executive director of Nurturely, a Eugene-based advocacy group for perinatal wellness, she knows these moments are a privilege — one that is rare for some parents.

“We have care that doesn’t serve Black birthing people, indigenous birthing people, trans birthing people, rural birthing people, it doesn’t serve them well,” said Little, referring to lack of access to providers, especially those who are trained in cultural competency. “It’s setting them up for a whole trajectory of inequities that compound as life goes.” 

Little’s concerns have grown as Oregon Medical Group prepares to end its obstetrics and gynecology services. Obstetrics providers from Oregon Medical Group have been contracting to deliver babies at McKenzie-Willamette Medical Center, and the hospital is now exploring options to find new doctors by Nov. 2, when contracts with the group terminate. 

That’s about a trimester away, a pivotal period for people who are pregnant, Little said. 

“People who already have a challenging time getting to appointments, who already have a lot of stress in their life, to have this thrown at them is completely unfair,” she said. “The unfortunate thing is, this is not new in our community.” 

How we got here

Oregon Medical Group announced in a July 14 email to patients that it will no longer provide OB-GYN services as of Nov. 26. The group cited a shrinking team, echoing a notice last year to patients when several primary care doctors left, forcing thousands to find new providers.

Oregon Medical Group — founded and initially owned by doctors — was purchased in 2020 by Optum, a national health care company and a division of UnitedHealth Group.

Of the OB-GYN team of at least 10, three Oregon Medical Group doctors have moved out of state, and three have decided to join a locally owned clinic, Women’s Care. The others’ plans are unknown.

Dr. Catherine York is the lead doctor of practice at Women’s Care, the largest OB-GYN group in Lane County. 

“With this group at Optum having the struggles that they’ve had over the years, with some attrition and loss of physicians to their communities and so forth, we have been able to retain some of that talent that was in that group, here in our group,” she said. “We’re really excited about that.”

Much work remains to ensure a smooth transition, with Optum assisting on medical record transfers and Women’s Care onboarding doctors at its new Garden Way location. The clinic will offer gynecology services similar to the neighboring Oregon Medical Group OB-GYN clinic that is closing, including preventive reproductive care, menopause management and cervical cancer screenings.

York did not offer specifics on scheduling and wait times but said she doesn’t expect them to be a significant problem.

Women’s Care clinics provide obstetric care for both routine and high-risk pregnancies, with deliveries performed at PeaceHealth Sacred Heart Medical Center at RiverBend. Although Women’s Care delivers at RiverBend, it remains independent and maintains autonomy over its practice.

In recent years, reproductive rights have become entangled in the blurred lines between church and state, raising concerns about what this could mean for care — especially if the area’s sole delivery hospital becomes RiverBend, which has a Christian-based mission. RiverBend does not offer abortions, according to hospital policy.

Since the Supreme Court’s 2022 Dobbs decision, which overturned Roe v. Wade, abortion access has varied by state. In places like Texas, women have reported being denied abortions even for ectopic pregnancies — a life-threatening condition in which a fertilized egg implants outside the uterus and cannot result in a viable birth.

In Oregon, abortion remains legal at all stages of pregnancy, with no additional restrictions beyond medical standards.

“An ectopic pregnancy is a medical emergency, and we treat those, and we have no religious conflicts,” York said.

While Women’s Care contracts with RiverBend full-time, the practice has been open to working with McKenzie-Willamette Medical Center.

“We don’t have a McKenzie-Willamette delivery option at this point. I don’t know what will happen in the future as far as that’s concerned,” York said. “We would be open to it. We appreciate McKenzie-Willamette, and we hope that they’ll continue to operate.” 

McKenzie-Willamette intends to keep its delivery unit open because it is “vitally important,” spokesperson Jana Waterman said. 

The for-profit hospital, owned by private entity Quincy Health, has already deemed some birth units “unsustainable.” Its in-house unit with midwifery nurses — a holistic practice that offers a more natural, participatory approach to prenatal, birth and postpartum care — shut down in 2023.

PeaceHealth’s stand-alone midwifery unit closed in 2019.

In a statement to Lookout Eugene-Springfield, spokesperson Jim Murez said, “PeaceHealth is firmly committed to providing safe, high-quality obstetrics and gynecology care for the Eugene-Springfield community. We are always monitoring the availability of health care resources in Lane County and preparing for any additional needs for care at our facilities.” 

‘We learn from each other’

In Lane County this year, nearly 1,300 people have given birth. About 73% delivered at RiverBend, while 18% gave birth at McKenzie-Willamette, according to preliminary data from the Oregon Health Authority. Others chose midwifery options, such as Our Community Birth Center, or delivered at home.

Advocates say the numbers reflect already limited options, particularly for people who have moved to the United States from other countries, like Maria Paz Aguirre. Aguirre, who grew up in Chile and lived in Ecuador before having her first son in the U.S., now lives in Eugene and advocates for the area’s Latinx community. Hispanic or Latino people make up about 10% of Lane County’s population.

She and her friend and colleague Roshny B. Martuscelli work at Nurturely with Little, who recently gave birth at home. Together, they work to address the complex challenges pregnant people face — challenges they also experienced during their own pregnancies. Martuscelli was pregnant with her third child during a recent wildfire smoke event in Eugene.

The tiny particles in wildfire smoke are harmful to everyone, but pregnant people face greater risks because their cardiac output can increase by up to 50%. 

When Martuscelli gave birth at McKenzie-Willamette, she called the experience disheartening, saying her requests for warmer temperatures — part of a cultural practice of welcoming a baby into a loving space — were ignored.

“There needs to be more emphasis on midwifery, and also midwives of color,” Martuscelli said, calling for long-term care that reflects patients’ backgrounds and environments.

“It’s hard to imagine what it would even look like to receive culturally responsive care,” she said. 

The organization is moving from its downtown Eugene location to a new community center in Bethel, which is already serving as a home base for multiple nonprofits including Eugene-Springfield NAACP and the Boys & Girls Club of Emerald Valley.

Nurturely’s move to a new lounge for parents, offering breastfeeding and postpartum support, is part of a broader effort to build a care network as OB-GYN services become strained and uncertain. It’s how the community is stepping up as systems around them — from corporate hospitals to federal leadership — falter. 

“In response to everything that’s happening right now, all the socioeconomical, climate crisis, we recognize, all of these fires that are happening at the same time. We recognize the value of community resilience, building cultures of support, for caregivers, for babies,” Aguirre said.

“We learn from each other.” 

The headline of this story has been updated.