By Ron Rocky Coloma
After more than two decades of providing a family-centered alternative to hospital births, Sagua Mañagu, Guam’s first freestanding birthing center, has closed its doors.
Established in July 2000, the center has been a cornerstone of maternity care on the island. Its closure, which will be followed by the planned shutdown of the Sagua MPG Clinic in February 2025, raises questions about the future of maternity services on Guam.
The demise of Sagua MPG gave birth to Famalao’an Wellness Center this year. The new clinic in Tamuning was founded by Dr. Mariana Cook-Huynh and Dr. Kelli Jarrett to meet Guam’s significant need for comprehensive women’s healthcare and obstetric services.
Both were formerly physicians at Sagua MPG. According to FWC’s website, Cook-Huynh and Jarrett decided to open their own practice when the clinic was anticipated to close.
“FWC is focused on helping women have healthy pregnancies, and we provide comprehensive obstetric care for all women,” the website states.
FWC also provides contraceptive services and other gynecologic services.
Meanwhile, Lina Leon Guerrero, general manager of Sagua Mañagu, reflected on the center’s journey, challenges and legacy.
The vision for Sagua Mañagu originated with Dr. Mary Grace Bordallo, Guam’s first CHamoru OB/GYN. After returning to the island in 1993, Bordallo worked in a local clinic and quickly recognized a need for alternative maternity care solutions.
“She saw firsthand that the number of expectant mothers on Guam exceeded the hospital’s room capacity,” Leon Guerrero said. “Dr. Bordallo also knew that women often have normal, healthy deliveries that don’t require hospitalization.”
In 1999, she co-founded Marianas Physicians Group with two other physicians, laying the groundwork for Sagua Mañagu. The birthing center opened a year later, welcoming its first baby on July 20, 2000.
Sagua Mañagu provided a family-oriented, low-intervention approach to childbirth, delivering more than 8,000 babies over the years.
“Our nurses and birthing assistants exemplified compassionate, patient-centered care,” Leon Guerrero said. “They upheld our philosophy of supporting families during one of the most important moments of their lives.”
“Dr. Bordallo’s vision literally came to life,” Leon Guerrero said. “It was a significant milestone for our island community, offering an alternative to hospital births and helping to alleviate the high volume of deliveries at Guam Memorial Hospital. For 22 years, Sagua Mañagu was a place where families were born.”
Despite its legacy, Sagua Mañagu faced mounting challenges in its final years. The Covid-19 pandemic brought unprecedented disruptions, straining healthcare facilities worldwide, including those on Guam.
“It was an incredibly difficult time for our patients, staff and families,” Leon Guerrero said. “After careful consideration, we decided to close the birthing center in December 2022 and focus our resources on the Sagua MPG Women’s Health Clinic.”
With Bordallo preparing for retirement, the clinic is also set to close its doors on Feb. 28, 2025. The decision, while bittersweet, marks the conclusion of a remarkable chapter in Guam’s healthcare history.
“While it’s the end of an era for our clinic, we are grateful for the opportunity to have served our community,” Leon Guerrero said. “We hope others will continue the legacy of care and support for the women and families of Guam.”
The closure of Sagua Mañagu and the Sagua MPG Clinic raises concerns about the availability of maternity services on the island. Leon Guerrero acknowledged the challenges but expressed optimism about the options that remain for expectant mothers.
Leon Guerrero also recommended the non-profit Todu Guam for maternity services and Department of Public Health and Social Services for prenatal care. “Deliveries will continue to be handled by private clinic physicians and GMH,” she added.
Leon Guerrero emphasized the importance of diversifying the maternity care workforce.
“Family practice obstetricians, certified nurse midwives and family practice providers bring valuable expertise and a personalized approach to care,” she said. “They can help ensure that families have access to the services they need during this important time.”
In preparation for the clinic’s closure, efforts have been made to support patients through the transition.
“We’ve encouraged patients to establish care with new providers well before March 2025,” Leon Guerrero said.
“We’ve also made helpful links and resources available online to assist in this process.”
Reflecting on the legacy of Sagua Mañagu and MPG, Leon Guerrero highlighted the profound impact they have had on Guam’s families.
“Our community will remember our staff and the care they provided,” she said.
“They built lasting relationships with patients, and their work was rooted in cultural values that celebrated family and supported patient autonomy.”
The philosophy of family-oriented care extended beyond the birthing center. The MPG clinic also played a pivotal role in women’s health, providing comprehensive services for over two decades.
“Our medical assistants, patient service representatives and billing office team were instrumental in delivering high-quality care,” Leon Guerrero said.
As Guam adjusts to the absence of Sagua Mañagu, the focus shifts to how maternity care will evolve to meet the island’s needs. Leon Guerrero noted that challenges persist, particularly in rural and remote areas like Guam.
“Much of healthcare will likely become hospital-based,” she said. “We’re seeing a trend toward hospitalists handling more deliveries. However, prenatal care will still be provided by physicians, nurse midwives and nurse practitioners in clinics.”
She also emphasized the need to recruit more healthcare providers to address the island’s growing demands. “We remain hopeful that new providers will step forward to support the women and families of Guam,” she said.
Leon Guerrero recognized the families and community members who supported the center over the years.
“Lots of people took a chance on the idea that childbirth could be a special experience in an environment that celebrates family,” she said. “Our success would not have been possible without them.”
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