Obstetrics Program in Antelope Valley to End

The only medical program in the Antelope Valley that allows poor women to have their babies in a hospital setting, whether they have health insurance or not, will be a casualty of budget cuts, Los Angeles County health officials said Monday.

The 6-year-old joint obstetrics program between county-owned High Desert Hospital , and private Antelope Valley Hospital will end Oct. 1 and is one in a series of cuts in the county’s health care system to bridge the department’s $655-million deficit.

Last year, 1,200 babies were delivered in the program.

So far, the Board of Supervisors has approved closing 28 of the county’s 39 clinics and health centers, and reducing hospital outpatient services by 75%.

County officials have warned that further cuts--including the closure of one or more of the county’s six hospitals--are possible if Los Angeles County fails to receive millions of dollars in state and federal revenue that supervisors included in the $12-billion budget they approved earlier this month.

In addition to eliminating High Desert’s joint obstetrics program, the health department said Monday that it will cut the Lancaster hospital’s skilled nursing facility by 30% and eliminate outpatient services for 11 specialties, including prenatal care, urology and eye treatment. Prenatal care will be handled at the area’s clinic, which will remain open.

At Olive View / UCLA Medical Center in Sylmar, a four-bed pediatric intensive care unit will be shut down, as well as inpatient psychiatry and a variety of outpatient services, including treatment for walk-in patients.

Ramasamy Mahadevan, a pediatrician at High Desert, said he helped start the joint obstetrics program in 1989 because too many pregnant women in the area were going without adequate medical care.

In the obstetrics arrangement, women receive prenatal care at the county hospital, deliver their babies at nearby Antelope Valley Hospital and then return to High Desert for pediatric services.

Mahadevan said that ending the program might push poor women back into the bad old days when some gave birth without ever receiving prenatal care. As a result, many of the children had low birth weights and other medical problems.

“This is really a severe loss to the community . . . I don’t know what will happen,” he said. “One thing that is possible though, is there might be deliveries in the [hospital] parking lot like there were before.”

A key element to the program’s success, Mahadevan said, was the ability he had to establish relationships with his patients--before and after they gave birth.

“If you lose the continuity for care, people will just come when they are sick,” he said.

Eliminating the obstetrics program will save the county $1.1 million, a health department spokeswoman said.

On Monday, officials at Antelope Valley Hospital said they will probably be able to deliver babies for poor mothers because most pregnant women are automatically eligible for Medi-Cal, the state’s health insurance program for the poor.

Bev Greer, the hospital’s vice president of business development, added, however, that doctors--not hospitals--ultimately decide how many Medi-Cal patients they will see. The physicians, she said, are reimbursed by Medi-Cal but only at a small percentage of the cost of the medical care they provide.

“The hospital has delivered those babies for years,” Greer said. But “the facility has to find doctors willing to do it, given the changes.”

The hospital recently opened a prenatal clinic in Lancaster and is planning a second one for Palmdale that will target some of the Medi-Cal population that currently uses High Desert.