Nicole O’Daniel won’t be able to give birth to her second child — due in early August — in the community where she lives.
Rather, she said her birth plan involves “going down the Hill,” making the half-hour trip from her home in Los Alamos to Presbyterian Española Hospital.
“Presumably, that’s where I’ll have this kiddo — although [I] would have preferred Los Alamos,” O’Daniel said.
By late June, giving birth at Los Alamos Medical Center will no longer be an option for expecting mothers. The 47-bed acute care facility, which is the sole hospital in Los Alamos County, announced plans late last month to discontinue labor and delivery services. Instead, it has partnered with Presbyterian Española Hospital and Christus St. Vincent Regional Medical Center in Santa Fe to send birthing patients elsewhere.
The move — the latest in a series of painful contractions in obstetric care for New Mexico patients, particularly those who live in rural areas — sparked disappointment and fear among Los Alamos parents and patient advocates. An online petition, led by O’Daniel and aimed at pressuring the hospital to reverse the decision, has more than 200 signatures.
“Twenty minutes can matter,” O’Daniel said. “And realistically, I understand there are folks who live in very, very rural places, where their closest hospital is two or three hours away, but when you live in a town with a hospital, you want at least some of the hospital services.”
Kristi McBride, executive director of First Born Los Alamos, a local home visiting program, said the change in services is already pushing some local families to establish prenatal care in Española or Santa Fe in anticipation of birthing there. That distance, she said, could result in delays in diagnoses or accessing support services — even in New Mexico’s healthiest and wealthiest county.
“Are people less likely to seek care because it is farther away?” McBride said. “And then what are the things that are either going untreated or leading to bigger problems?”
She added, “We are a well-resourced community, and now this is a major resource that will no longer be accessible to us. It certainly hurts.”
Los Alamos Medical Center spokesperson Andrew Cummins wrote in an email the shift in services was “a model change — not a closure or withdrawal of obstetric care,” even though the hospital will no longer provide inpatient labor and delivery.
It stemmed from a declining number of births at the hospital, as well as physician and nursing labor shortages, Cummins added.
“These low volumes make it increasingly difficult to sustain a safe, high‑quality inpatient labor and delivery program,” Cummins wrote. “Transitioning to a regional model allows LAMC to protect patient safety, ensure continuity of care and connect families to a broader level of specialty resources when needed.”
Losing obstetrics
The change at Los Alamos Medical center is another local example of a nationwide phenomenon: Labor and delivery units at hospitals across the U.S. have shuttered in recent years, with hospital leaders largely attributing the closures to staffing issues and a baby bust.
Cummins pointed to fewer than 25 births at Los Alamos Medical Center in 2025, with even fewer expected this year.
After conducting a nationwide county-by-county review, researchers with the Maternity Care Team at the University of Minnesota’s Rural Health Research Center found 60% of rural counties and 38% of urban counties in the U.S. did not have any hospital-based obstetric services in 2023.
Their state-level analysis, published in January, shows New Mexico counties lost more hospital-based obstetric services than they gained between 2010 and 2023.
Three counties lost all services during that period. That includes San Miguel County, which lost hospital-based obstetric care in 2022 with the permanent closure of the maternity ward at Alta Vista Regional Hospital in Las Vegas, N.M.
‘Reimagining’ care
Los Alamos Medical Center made its announcement in a news release April 24: The hospital would participate in a “regional model” for obstetric care, in collaboration with CHRISTUS St. Vincent and Presbyterian Española.
“We are pleased to be able to reimagine and offer a new and more comprehensive model of obstetrical care here in Los Alamos,” Dr. Justin Green, chief of staff at Los Alamos Medical Center, said in a statement.
While deliveries will take place at hospitals in Española or Santa Fe “as part of the regional approach,” the news release said, Los Alamos Medical Center will continue to provide prenatal, postpartum and women’s health services.
The hospitals will implement the new model over the next few months, with delivery services transitioning in late June.
Los Alamos Medical Center’s emergency department will still be prepared to manage pregnant and postpartum patients in emergent cases, Cummins noted.
“Our team will continue to provide prompt medical screening, stabilization and, when needed, coordinate timely transfers to Christus St. Vincent, Presbyterian Española Hospital or another regional obstetric provider,” he added.
Hospitals ready to step in
Brenda Romero, chief executive of Presbyterian Española Hospital, said in a statement the hospital is prepared to absorb additional births from Los Alamos Medical Center patients.
“Our goal is to help ensure continued access to quality obstetric care for our northern New Mexico neighbors,” Romero said. “Patients receiving prenatal care at Los Alamos Medical Center can choose the delivery location that’s right for them, including Presbyterian Española Hospital.”
Though policy shifts have resulted in interruptions in OB-GYN coverage at Christus St. Vincent, the Santa Fe hospital said it, too, has the staff and infrastructure in place to manage additional patients from Los Alamos, spokesperson Arturo Delgado wrote in an email to The New Mexican.
“CHRISTUS St. Vincent is prepared to accommodate the additional patient volume associated with this transition,” Delgado wrote. “Through our partnership with OB Hospitalist Group, the hospital now provides 24/7 labor and delivery coverage for expecting mothers.”
Calls for reversal
Still, the Los Alamos hospital’s announcement brought fear and anxiety to some families in the community, including mothers planning to give birth at the local medical center, O’Daniel said.
“Folks are nervous about going down the Hill,” she said. “Plenty of folks choose to because that’s what they want to do, but it has been kind of pushed upon folks to give birth down the Hill now.”
O’Daniel’s petition urges Los Alamos Medical Center officials not to close the hospital’s labor and delivery unit, encouraging them to instead “work with providers and the community to continue providing this vital service.”
It includes more than a dozen testimonials from parents, many of whom shared positive experiences with Los Alamos Medical Center providers.
Cummins said hospital leaders are aware of the petition and have reached out to O’Daniel directly to discuss questions and concerns.
“LAMC is committed to ongoing dialogue and to ensuring appropriate outreach and education for our patients and community members as we navigate this transition,” he wrote.
First Born also called on Los Alamos Medical Center to reverse course.
“We hope that LAMC will reconsider this decision so Los Alamos County residents can be assured that local healthcare is there when they need it,” McBride said.
Birthing in a nearby hospital can also be emotionally and logistically beneficial for families — something O’Daniel experienced firsthand while giving birth to her first child.
Her daughter, now 2, was born premature, requiring a stay in the neonatal intensive care unit in Albuquerque. O’Daniel said it meant the family had to live in Albuquerque for weeks during her care.
The past preterm labor made her ineligible to receive care at Los Alamos Medical Center for her second pregnancy, she added.
“As much as there are serious cases and things that you do need to go to bigger hospitals for — like having a preemie — there’s also the standard, normal labor and delivery cases,” she said. “It just feels like, why can’t we have this service close to home?”