Hannah Jarand gave birth to her fourth child, a boy, at Providence St. Vincent Medical Center in Portland on January 9.
Because of the issues in her prior pregnancies, Jarand claimed that this was a high-risk pregnancy.
According to her, I spent nine months working closely with my OB to develop a care plan that would prevent previous issues. My OB has been really kind and helpful, helping me at every stage to make sure everything was ready for a successful and easy birth.
Although the birth went well, her newborn had breathing problems soon after and was taken to the neonatal intensive care unit. Meanwhile, Jarand was moved to the level above to recuperate.
The following morning, Jarand woke up shortly before the approximately 5,000 nurses at eight Providence hospitals in Oregon, as well as hospitalists at St. Vincent and Providence Women’s Clinic doctors, started a strike that is now in its third week.
Statistics from the Oregon Health Authority dating back to 2008 show that Providence St. Vincent delivers more infants annually than any other hospital in the state. Approximately one in five births in the state are attributable to the Providence health system as a whole.
Additionally, St. Vincent has a pediatric critical care unit, perinatal special care unit, and an advanced neonatal intensive care unit.
However, among the striking employees are Providence Women’s Clinic physicians and nurse midwives who provide prenatal care and work shifts at hospitals, including St. Vincent, to be with patients during delivery, as well as St. Vincent obstetric hospitalists who frequently give birth when a private practice OB-GYN is unavailable.
Even before the striking workers issued their mandatory 10-day notice, Jarand claimed to have experienced panic attacks over the prospect of a strike by the time she was in labor. Despite this, she claimed that the abrupt change left her feeling quite uneasy.
Jarand reported that she was unable to call a nurse to relieve her pain or provide an update on her newborn for several hours after arriving at the hospital the morning after her delivery, just as the hospital’s replacement staff were taking over.
She expressed her support for her care team, who are now on strike, and expressed her displeasure with Providence’s alleged lack of direction over ongoing treatment. Because she felt deceived by Providence’s assurances that care would not change during the strike, Jarand said she spoke with The Oregonian/OregonLive.
I felt so small all of a sudden, and I was terrified because I didn’t know how my care would be provided,” she added.
According to Providence, the health system had informed patients that some changes would be required at the women’s clinics, disputing Jarand’s description of the system’s communications to patients both before and after the strike started.
Additionally, it stated that her experience was not common among patients who received care during the strike. Jarand claimed the health system called her and offered to cancel her hospital stay expenses after The Oregonian/OregonLive reached out to Providence for this article.
According to a statement from the hospital system, hospital operations are still going well, and Gary Walker, a Providence spokeswoman, claimed that hospitals in the health system are still delivering babies despite the strike.
In a statement, Providence said that it had hired 2,000 replacement nurses for its hospitals and that its facilities have enough staff to properly deliver treatment, including childbirth, throughout the strike.
Finding doctors and advanced care specialists to cover for the striking hospitalists and women’s clinic staff has proven more difficult for the non-profit Catholic health system.
About 45 patients with near-term pregnancies at Providence Women’s Clinic will be permanently transferred to other health systems and practices, the city announced on Wednesday.
According to health system officials, Providence is deeply grateful to the Oregon health systems, community partners, and other clinicians who are stepping up to care for our pregnant patients.
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For the duration of the strike, Providence has reduced the number of its women’s clinics from six to two: one in Beaverton and one in northeast Portland. The absence of clinicians at Providence’s chain of women’s clinics has also resulted in fewer appointments.
Physicians and healthcare professionals at St. Vincent and the women’s clinics who are on the picket line express their frustration at having to deal with more patients.
Hospital maternity units typically run at a loss or with extremely thin profit margins.Because they need operating rooms that are always available and round-the-clock staff, including obstetric doctors and anesthesiologists, maintaining labor and delivery units can be expensive. Compared to other practices, their malpractice insurance rates are frequently higher.
According to Julia Interrante, a research fellow and statistical lead at the University of Minnesota’s Rural Health Research Center, who is not particularly familiar with Providence’s operations, her research has revealed that insurance reimbursements for maternity care are typically bundled payments that are a flat rate for services provided throughout a pregnancy, including prenatal care, labor and delivery, and postpartum care. This has resulted in a shortage of physicians and nurses in many U.S. maternity wards. According to her, the costs of providing the service are frequently not met by this payment mechanism.
Maternity care services are typically underpaid for the real cost of providing them under both Medicaid and private insurance, according to Interrante.
According to the women’s clinic providers and hospitalists at St. Vincent, the reason for their strike is the increasingly difficult working conditions. They claim that they are unable to provide the kind of care they feel their patients deserve because of a lack of staff and other budget cuts.
“The most important thing we’re asking for is help with staffing, but Providence won’t listen to us,” said Dr. Jennifer Lincoln, an obstetrics hospitalist at St. Vincent. More money is not the reason for the strike.
According to a statement from Providence officials, an obstetrics hospitalist and two women’s clinic providers—an OB-GYN and a midwife—staff St. Vincent’s labor and delivery unit during regular business hours. Additionally, St. Vincent is home to two private clinics that assign two providers per shift.
However, despite the private practice providers, St. Vincent’s doctors indicated the staffing is still inadequate.
According to Lincoln, the doctors at Providence Women’s Clinic and other private practice physicians occasionally need assistance since they are covering the ER or have their own patients in delivery. For high-risk patients, we OB hospitalists offer inpatient care. When it comes to labor and delivery emergencies, we are the professionals.
Lincoln stated that in the few instances where we are drowning and are unable to safely deliver treatment, the OB-GYN hospitalists at St. Vincent are requesting the opportunity to call in an additional OB hospitalist or to have a role in closing admissions.
On Friday, January 10, 2025, employees and supporters demonstrate outside Providence St. Vincent Medical Center in Portland.Meagher, Sean/The Oregonian
In order to ensure a seamless and stress-free delivery, Jarand had prepared in close collaboration with her care team at the Providence Women’s Clinic at St. Vincent. She claimed that although the actual delivery went smoothly, the days that followed were anything but.
Jarand claimed that the temporary nurses who were sent in to cover for the striking staff frequently neglected to give her her prescriptions and had trouble navigating the hospital’s systems. After hours of what she described as severe pain from her epidural and delivery, Jarand said she tried to understand the new difficulties the replacement nurses faced, but her tolerance eventually wore thin.
To make matters worse, Jarand claimed that the new nurses couldn’t find the right sized flanges for her breast pump, which prevented her from efficiently pumping milk. According to Jarand, she had not experienced this issue during previous deliveries at St. Vincent.
The hospital system cited a dozen largely handwritten comments praising specific replacement nurses and the institution’s staff as proof that Jarand’s experience did not mirror that of other patients. Addressing managers with sincere gratitude for keeping the doors open, the replacement crew is beyond beautiful.
Citing health privacy rules, the system censored names and other information. The Oregonian/OregonLive was unable to interview the patients as a result.
Additionally, the health system supplied a letter from OB-GYNs who worked at Providence during the strike, attesting to the excellent care that was given during this period and the frequent expressions of thanks from our patients.
We also want to dispel any rumors that our replacement nurses are in some way unqualified or providing suboptimal care, wrote the OB-GYNs, who included Dr. Carol Suzuki, St. Vincent s division chief of women and newborn services and Dr. Mike Davis, chair of the OB-GYN department.
Jarand is still unsure of where to go for postpartum follow-up care.
Before going into labor, Jarand claimed that a manager at the Providence Women’s Clinic had given her the assurance that care would be provided at the clinics even in the event of a strike. Signs posted in the hospital after the strike began offered similar assurances, saying the strike will not affect your ability to receive treatment here and you can expect the same quality of care you ve always received at Providence St. Vincent Medical Center.
Jarand reported that she experienced concerning discomfort after leaving the hospital and going home. Three postpartum procedures had been performed during her third pregnancy, and she had discussed potential risks with her doctor in detail this time.
But when she sought to see a doctor at the women s clinic, she said she was told by a nurse on a helpline to go to the emergency department. Not wanting to risk a communicable illness she could spread to her baby, Jarand declined, and the women s clinic instead scheduled her for the next available appointment with a midwife, a week and a half later, on Jan. 27.
Dr. Ben LeBlanc, chief executive of Providence Medical Group Oregon, said in a statement that the women s clinics continue to provide postnatal care to patients during the strike. He said decisions about the type of provider to schedule are made in consideration of each patient s situation and preferences and that midwives working at the clinic are working side by side with an OB-GYN and other specialists.
Jarand, however, worries the care that would be provided by a midwife rather than a doctor would not be adequate given her earlier complications.
Our last child was this one. I was looking forward to it as kind of a grand finale, Jarand said. Instead, she said, I felt totally robbed of the care that I expected.
–Kristine de Leoncovers consumer health, retail, small business and data enterprise stories. Reach her [email protected].
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