Karyn Karp, a certified registered nurse anesthetist with more than three decades of experience, has provided pain relief for the labor and delivery department at Petaluma Valley Hospital for the past 15 years.
As a contractor through an outside anesthesia group, M. Atchison CRNA, Inc., her work includes providing anesthesia for cesarean section surgeries, administering epidurals for women in labor, and similar services.
Karp said her group at Petaluma Valley Hospital originally was made up of only about five or six nurses, but became smaller over time due to retirements and the death of one employee.
As a result, “Basically all that was left as a full-time person was me,” Karp told the Argus-Courier this week. “And because our salaries had never changed over the 15 years that we had been there, we could never recruit, so we never got any (other) full-time providers.”
Karp’s situation became all the more urgent two weeks ago, when the owners of Petaluma Valley Hospital announced plans to close the hospital’s Family Birthing Center. Those affected in the community are still reeling – and asking questions, particularly with regards to the department’s contracted anesthesiologists.
Providence, which owns the hospital, has said the decision to close the birthing center was made after it received notice of termination of obstetric anesthesia coverage at the center effective Jan. 31.
Providence added that it was able to secure temporary anesthesia coverage at the center – but that without permanent coverage it cannot continue to operate the center safely. The short-term contract expires in March.
“This decision was not made lightly,” Providence executives said in their Jan. 18 statement announcing the decision. “We have thoroughly reviewed all available options, including sending out a request for proposal to regional and national medical groups for obstetric anesthesia coverage. Despite our continued efforts, we realize the only option is to close the Family Birthing Center due to safety concerns.”
The announcement, released during a board of directors meeting of the Petaluma Health Care District, sent shockwaves through the local medical community, including Karp.
Karp said her group’s administrator had tried to speak with Providence in the past to try to increase staff pay, “without any success at all.” Providence did not immediately respond to a request for comment on Karp’s assertions.
Due to the hardship in hiring more staff to give Petaluma Valley Hospital around-the-clock anesthesia services, the group was forced to make the decision to notify Providence that it would no longer be able to provide those services, she said.
Karp said the group’s administrators gave verbal notice to Providence of the decision to not renew their contract with the hospital on Sept. 22, before submitting a written 90-day notice on Oct. 2.
But Karp said she didn’t expect the hospital to completely shutter its Family Birthing Center in response.
“My reaction was shock,” she said.
Future uncertain
In light of Providence’s anesthesia services contract expiring – resulting in no anesthesiology services past March at Petaluma Valley Hospital’s well-regarded birthing center – it remained unclear when the final closure of the birthing center would actually take place.
The Petaluma Health Care District, which sold the hospital to Providence two years ago, said closing the Family Birthing Center would violate a 2021 purchase agreement requiring Providence to keep its birthing center open for at least five years.
Ramona Faith, CEO of the Petaluma Health Care District, said last week the district intends to hold Providence to the agreement. She said there’s a well-defined process that must be followed if Providence wants to discontinue or make substantive changes to services.
“Right now, until we have information, until we can actually review all the rationale and better understand why they can't find anesthesia and why they feel they need to close, they need to continue to operate it,” Faith said.
Faith said Providence has made “misleading” statements that give the impression that the district is working with them to ensure a transition plan for closure. “We're not working with them on a transition plan to close the unit,” she said.
Until the issue is resolved, hospital leadership, staff, mothers and other community members remain concerned at what the birthing center’s closure would mean: expectant mothers would have no birthing hospital anywhere between Santa Rosa and Marin County.
As for Karp, she said that although her own contract with the group ultimately expired, she has since established a work arrangement with a physician anesthesiology group that covers the main operating room of Petaluma Valley Hospital.
“So I will be providing some coverage services for labor and delivery moving forward, just not full-time,” she said.
The board is set to further discuss the issue at its next regular meeting on Feb.15. Concerned citizens and hospital staff announced they are planning a rally in support of the birthing center on the same day.
Press Democrat reporter Martin Espinoza contributed to this report. Amelia Parreira is a staff writer for the Argus-Courier. She can be reached at amelia.parreira@arguscourier.com or 707-521-5208.
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