Community Fights to Keep Damariscotta’s Birthing Unit Open

Margaret Reynolds, cofounder of the Miles Delivers Action Coalition, poses with her son Otto during a joint press conference on July 24 alongside Maine Democratic gubernatorial candidate Hannah Pingree.

DAMARISCOTTA, Maine – Artist Bailey Romaine and partner Ed Vlcek await their first child with growing concern. The local hospital in Damariscotta, where they planned the birth, is considering closing its labor and delivery unit come December. This potential shutdown poses a risk, forcing them to travel over an hour to the nearest hospital amid winter conditions.

The looming closure affects not only them but also numerous residents in the rural region. If it happens, giving birth could become less safe. In Maine alone, 11 birthing units have closed over the last decade. A strategic local group is determined to prevent another closure.

Community Activism Takes Root

On August 6, the board of MaineHealth will vote on whether to close or maintain the obstetrics department at Lincoln Campus, locally known as Miles Hospital. The Miles Delivers Action Coalition, a grassroots organization founded in May, is making a stand. Arguing that the unit provides essential services, they have rallied about 10,000 supporters.

Margaret Reynolds, speaking at an event with gubernatorial candidate Hannah Pingree, underlined the importance of local birthing options. Young families, she said, prefer locations where they can safely and conveniently welcome children. Pingree added that the closure represents not just a health crisis but also an economic one for Maine.

MaineHealth cites a lack of OB/GYNs and says it’s not safe to keep the unit open. Despite this, the coalition remains intent on drawing attention to the state’s broader maternity care issue. Politicians from both parties, including outgoing Governor Janet Mills, support their cause.

Leah Hurwitz, a parent who experienced a high-risk birth, worries about the effect of the potential closure on future mothers. The coalition remains steadfast, promising to keep up the fight even after the board’s decision.

Challenges of Rural Maternity Care

Maine is witnessing the rapid disappearance of rural hospital-based maternity care, second only to West Virginia.

Since 2020, nearly 150 rural maternity units have closed across the U.S. A significant portion of rural counties now lacks hospital-based birthing services, a trend that MaineHealth appears to contribute to by shuttering its facilities.

The fast-acting coalition began in May when Reynolds learned that the unit where her child, Gabriel, was born, faced closure. Together with her friends, they established the group and quickly garnered local support through community events, even hosting gatherings at Reynolds’ home.

Harnessing local resources, they formulated potential solutions. By engaging with health experts, the group developed alternative staffing models and sourcing strategies for recruiting medical personnel. They attracted surprising allies both inside and outside the health system, including board members, medical providers, and donors.

Struggle Against Economic Realities

Operating rural obstetrics units presents financial challenges. Generally, rural birth rates are low, and the availability of OB/GYNs is limited. As insurance coverage decreases, hospitals face rising costs for uncompensated care. A coalition member unearthed financial data they claim proves Miles Hospital’s profitability versus other MaineHealth facilities.

Despite these findings, the primary concern expressed by MaineHealth is staffing. Heavy reliance on temporary OB/GYNs challenges meeting coverage needs. This has led to efforts to redirect patients to alternate locations, which could extend travel times significantly.

Family physician Tim Goltz warns that removing OB services at Miles Hospital could cause unnecessary risks and complications to mothers and newborns. He emphasizes that longer travel distances increase the risk of severe complications or death.

Next Steps in the Fight

The coalition remains vocal in its demands. They criticized the CEO’s remuneration, contending that leadership should find better solutions rather than cutting services. Despite efforts, MaineHealth’s response to alternative proposals remains lukewarm.

Asserting their legal stance, the coalition recently filed a lawsuit to block the vote on shutting down services. Moreover, they submitted a rule-making petition to enforce a new law requiring more extended notice periods before such closures.