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One Maine community's fight to save a birthing center
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− Fresh Air Wild Card with Rachel Martin It's Been a Minute Embedded Get NPR+ More Podcasts & Shows Search Newsletters NPR Shop Get NPR+ Tiny Desk New Music Friday All Songs Considered Music Features Live Sessions About NPR Diversity Support Careers Press Ethics One Maine community's fight to save a birthing center In mid-coast Maine a grassroots coalition is fighting to prevent the proposed closure of Miles Hospital's labor and delivery center.
+ Fresh Air Wild Card with Rachel Martin It's Been a Minute Embedded Get NPR+ More Podcasts & Shows Search Newsletters NPR Shop Get NPR+ Tiny Desk New Music Friday All Songs Considered Music Features Live Sessions About NPR Diversity Support Careers Press Ethics Maine community fights to save rural labor and delivery center With maternity care deserts growing around the country, a grassroots coalition in Maine launched a strategic attack to prevent the proposed closure of a rural labor and delivery center.
− Healthcare One Maine community's fight to save a birthing center August 4, 20264:16 PM ET Heard on All Things Considered By Elaine Appleton-Grant Maine birthing center fight Listen · 5:21 5:21 Transcript Toggle more options Download Embed Embed "> <iframe src="https://www.npr.org/player/embed/nx-s1-5910852/nx-s1-9875144" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player"> Transcript In mid-coast Maine a grassroots coalition is fighting to prevent the proposed closure of Miles Hospital's labor and delivery center.
+ Healthcare How a community in Maine is fighting to save their birthing center Updated August 5, 202612:55 PM ET Originally published August 4, 20264:16 PM ET Heard on All Things Considered By
Elaine Appleton-Grant
Miles Delivers Action Coalition cofounder Margaret Reynolds, center, stands with her son Otto at a joint press conference July 24 with Maine Democratic gubernatorial candidate Hannah Pingree (left).
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MARY LOUISE KELLY, HOST:
In rural America, hospitals are losing maternity services fast.
+ Elaine Appleton Grant hide caption
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DAMARISCOTTA, Maine — Artist Bailey Romaine, 37, was thrilled when she learned she was pregnant with her first child.
− In Maine, 11 of the state's birthing units have closed, another is under threat.
+ She and her partner, landscaper Ed Vlcek, have spent the last five years making their home in midcoast Maine a "natural paradise" for a child to grow up in.
− But as Elaine Appleton-Grant reports, an organization is fighting aggressively to save it.
+ They live on the end of a peninsula, near a lighthouse.
But now, instead of looking ahead to the January birth with excitement, they're anxious.
− We'll note this story includes vivid descriptions of giving birth.
+ The hospital they were counting on for the birth, in the coastal town of Damariscotta, may close its labor and delivery unit in December. If it does, they'll be an hour or more from the next nearest hospital."
Late January would be peak blizzard time. Just to get up to Damariscotta from where we live is a pretty windy little state road that is not very well plowed in the winter," Romaine says.
− ELAINE APPLETON-GRANT, BYLINE: On Thursday, August 6, the trustees of MaineHealth will decide whether the obstetrics department at Miles hospital in Mid-Coast Maine will close.
+ Shots - Health News She's trying to open a birth center near a maternity desert.
− MaineHealth is the state's largest nonprofit health system.
+ It's not easy The potential closure is a worry for many in this rural region — and a rapidly growing problem around the country.
− A grassroots group is battling to protect the service - a service they say can mean the difference between life and death.
+ When labor and delivery services aren't accessible, giving birth becomes riskier.
− Their campaign took off on June 2 in a school gym packed with nearly 300 people.
+ And in Maine, where 11 birthing units have shut down in a decade, an exceptionally strategic local group is taking a stand to save this one.
On August 6, trustees of MaineHealth, the state's largest nonprofit health system, will vote whether to close or preserve the obstetrics department at MaineHealth Lincoln Campus, known locally as Miles Hospital.
Ed Vlcek and Bailey Romaine.
− At the mic, Leah Hurwitz describes her 8-month-old baby's birth at Miles.
+ The Bristol, Maine couple is expecting their first child in January 2027.
− She was breech.
+ Elaine Appleton Grant hide caption
The fast-moving grassroots group fighting the $4 billion nonprofit health care behemoth is called Miles Delivers Action Coalition, Founded in May, the group has rallied some 10,000 supporters. It's making the case that the birthing unit provides a life-and-death service the state can't afford to lose.
− (SOUNDBITE OF ARCHIVED RECORDING)
LEAH HURWITZ: (Crying) Before I could fully process what was happening, my water broke and I felt a foot coming out of me.
+ "Labor and delivery units all over the state already have wait lists… We refuse to let the preventable deaths of our friends and their babies happen when the issue is whether or not we can find staff to work here," said cofounder Margaret Reynolds, speaking at a press conference alongside Democratic gubernatorial candidate Hannah Pingree.
Health Bracing for federal cuts, some states are already paring back Medicaid services Pingree noted that young families don't move to communities where they can't give birth.
− By the time we arrived, my daughter was well on her way.
+ She referenced one of the coalition's signs: "What happens if you can't be born here and you can only die?" "It's pretty stark," she said. "This isn't just a healthcare crisis, a safety crisis. This is an economic crisis for our state."
MaineHealth, for its part, says it's been suffering from a shortage of OB/GYNs since 2020 and it's not safe to keep it open.
− APPLETON-GRANT: Her daughter's head got stuck.
+ Whatever happens with the closure vote Thursday, the group's leaders say they will not let this issue go.
− She lost oxygen for seven minutes.
+ Their advocacy work has brought attention not only of this specific birthing center but of the maternity care crisis facing the entire state.
− She wonders, what if she'd been five minutes later?
+ Now, politicians of all parties are urging MaineHealth to preserve the birthing center including outgoing Governor Janet Mills, U.S. Rep. Chellie Pingree (Hannah Pingree's mother), and a delegation of statehouse lawmakers.
− (SOUNDBITE OF ARCHIVED RECORDING)
HURWITZ: (Crying) My daughter would not be alive.
+ Leah Hurwitz's eight-month-old baby, Veda, sports a Miles Delivers sticker at a press conference in Damariscotta, Maine on July 24.
− I would not be alive.
+ Hurwitz had a dangerous breach birth that needed urgent care — she worries about risks to other parents should Miles be shut down.
− She is alive because I live 10 minutes from a qualified labor and delivery department with a qualified OB on staff.
+ Elaine Appleton Grant hide caption
Rural and poorer urban areas are losing hospital-based maternity care at an alarming rate. By the end of this year, nearly 150 rural birthing units will have closed since 2020 around the country, leaving families, doctors, and emergency medical responders with increasingly fraught decisions.
− APPLETON-GRANT: The majority of rural hospitals in America no longer deliver babies, and more than 10% of existing maternity units are in danger of closing.
+ Public Health Maternity care in rural areas is in crisis.
− Dr.
+ Can more doulas help?
− Tim Goltz, a longtime Miles family physician, doesn't want this to be one of them.
+ Today, 60 percent of rural counties in America have no hospital-based birthing services, and closures aren't slowing down.
− TIM GOLTZ: There's no doubt in my mind that if OB goes away at Miles that there will be mothers and babies who die because of that decision.
+ Maine is at the forefront. According to the Center for Health Care Quality and Payment Reform, Maine is losing maternity care at the second fastest pace in the nation, after West Virginia.
− APPLETON-GRANT: Three local moms are determined not to let that happen.
+ Miles Delivers is making the issue hard to ignore.
− Margaret Reynolds, Moira Rosie Richards (ph) and Leslie Wolfe spun up the Miles Delivers Action Coalition in late May.
+ The coalition was spun up practically overnight by three friends — local mom Margaret Reynolds, Moira "Rosie" Richards and Leslie Wolf.
− It's now an influential advocacy group that claims some 10,000 supporters.
+ On May 14, Reynolds learned that the birthing unit where she'd had her two-year-old, Gabriel, could close.
Within a few days, the cofounders called for a "morning of action" at Reynolds' home.
Nearly 100 people arrived, including one woman who brought a bouncy house for the kids.
− Reynolds learned about the potential closure from her Miles midwife.
+ "All these moms I had never met showed up at my front yard," Reynolds says.
− That night, she texted Rosie Richards.
+ "All the kids went into the bouncy house and we all just talked."
They treated the group like a startup, with people leading research, legal, political advocacy, communications.
− They quickly posted flyers for a morning of action.
MARGARET REYNOLDS: And it was just, like, all these moms I had never met showed up at my front yard.
+ They weren't looking just to make noise.
− And one of the moms brought a bouncy house, and so all the kids went into the bouncy house, and we all kind of just talked.
+ Rather, they wanted to come up with real solutions that could convince MaineHealth to keep the birthing center open by addressing the problems that put it at risk.
− APPLETON-GRANT: They conducted their opposition as if they were a startup with people leading research, legal, political advocacy, communications.
+ "Instead of assuming closure was inevitable, we started looking for other ways forward," Reynolds says.
− They would seek solutions.
+ They met with physicians, nurses, midwives, lawmakers, and rural health experts nationwide. "These conversations led to alternative staffing models. They led to recruitment strategies and funding opportunities." They attracted all kinds of people — some of whom surprised them.
− REYNOLDS: One of the most amazing things is that almost immediately people started coming to us from inside.
+ "Almost immediately, people started coming to us from inside," Reynolds says.
− So we had their own board members come to us, at least three of them.
+ "We had their own board members come to us.
− Do anything you can.
APPLETON-GRANT: The reality is rural birthing units lose money.
+ Do anything you can."
Rural obstetrics departments lose money.
− Birth rates are declining and OBGYNs are in short supply.
+ Nationally, birth rates are declining and OB/gyns are in short supply.
− The coalition didn't dispute that.
+ With millions losing insurance as a result of Medicaid cuts and the end of Affordable Care Act subsidies, hospitals' uncompensated care costs are rising.
The coalition doesn't dispute that.
− But what they did have a problem with was what they call a lack of transparency on the part of MaineHealth.
+ But they've been fighting what they call a lack of transparency on MaineHealth's part.
− So they set out to understand the facts underneath the organization's arguments, which included money.
+ From the start, they set out to understand the facts underneath the organization's arguments – which included money.
− REYNOLDS: One of our coalition members, he pulled together just a massive amount of information on their financial situation.
+ "One of our coalition members just went into investigative mode, and he pulled together a massive amount of information on their financial situation," Reynolds says.
− APPLETON-GRANT: Then they published data showing Miles hospital is more profitable than most of MaineHealth's 12 hospitals.
+ They published data showing Miles hospital is more profitable than most of MaineHealth's 11 other hospitals.
After that, Miles President Cindy Wade said in a community meeting, "I want to emphasize that this assessment is not driven by finance."
Instead the healthcare company started talking about staffing struggles.
− Then MaineHealth stopped arguing that finances play into the decision.
+ It relies heavily on temporary ob/gyns.
− They now emphasize staffing struggles.
+ When it can't cover a shift, it diverts patients elsewhere.
"Our practicing obstetricians and gynecologists have great concerns about the inability to reliably staff a labor and delivery unit and having confusion in patients' minds about where to go when they actually start laboring," says MaineHealth CEO Dr.
− When they can't cover a shift, they divert patients elsewhere.
+ Andy Mueller.
− ANDY MUELLER: Our practicing obstetricians and gynecologists have great concerns about the inability to reliably staff a labor and delivery unit and having confusion in patients' minds about where to go when they actually start laboring.
+ To help solve this, the coalition has reached out to OB/GYNs willing to work at Miles and worked with clinicians to design what they say are more sustainable ways to cover 24/7 care.
− APPLETON-GRANT: That's MaineHealth's CEO, Andy Mueller.
+ MaineHealth's reception to the coalition's ideas has been lukewarm.
− Pregnant women, he says, can move to two other MaineHealth hospitals.
+ And it argues, pregnant women can instead move their care to two other MaineHealth hospitals.
The health system claims that moving patient care would only add 18 minutes to the average mom's drive times.
− The health system claims that would only add 18 minutes to moms' average drive times. But the coalition points out that for many people, drive times would be an hour or more, especially with tourist traffic or bad weather. Dr. Tim Goltz again.
+ But the coalition points out that for many people, drive times would be an hour or more — especially with tourist traffic or bad weather.
− GOLTZ: I think that the literature is very clear that the further you have to travel to deliver a baby, the higher the risk is of serious complications and death.
+ Longtime Miles family physician Tim Goltz is worried.
− APPLETON-GRANT: Working with doctors, the coalition offered MaineHealth clinician resumes and proposed more sustainable ways to cover 24/7 care.
+ "There's no doubt in my mind that if OB goes away at Miles, that there will be mothers and babies who die because of that decision," he says.
− The reception has been lukewarm.
+ "The literature is very clear that the further you have to travel to deliver a baby, the higher the risk is of serious complications and death."
The coalition continues to push the health system hard.
− The coalition has been pushing hard.
+ It posted on social media that "A CEO paid $2.2 million should be expected to find solutions, not simply eliminate services."
When asked about that, Mueller, the system's CEO, told NPR that MaineHealth had tried.
"I think we have to put our heads together to try to find alternatives," he said.
− They posted on social media, quote, "a CEO paid $2.2 million should be expected to find solutions, not simply eliminate services." When asked about that, CEO Andy Mueller said they'd tried.
+ "Unfortunately, [we] haven't found any that work at the present time."
On Wednesday, the coalition announced that it is filing a lawsuit against MaineHealth, seeking an emergency injunction in an attempt to "prohibit MaineHealth from conducting any final vote authorizing termination of Labor and Delivery services" at Miles.
− MUELLER: I think we have put our heads together to try to find alternatives and unfortunately haven't found any that work at the present time.
APPLETON-GRANT: On July 31, outgoing Governor Janet Mills wrote to the MaineHealth Board of Trustees, urging them to delay any decision for two years and to consider other alternatives.
+ They also filed what's called a "rule-making petition" with Maine's health and human services department.
− The state's decline in birthing facilities is becoming an issue in the race to select a new governor. For NPR, I'm Elaine Appleton-Grant in Belfast, Maine. Copyright © 2026 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information. Accuracy and availability of NPR transcripts may vary. Transcript text may be revised to correct errors or match updates to audio. Audio on npr.org may be edited after its original broadcast or publication. The authoritative record of NPR’s programming is the audio record. Facebook Flipboard Email Read & Listen Home News Culture Music Podcasts & Shows Connect Newsletters Facebook Instagram Press Public Editor Corrections Transcripts Contact & Help About NPR Overview Diversity NPR Network Accessibility Ethics Finances Get Involved Support Public Radio Sponsor NPR NPR Careers NPR Shop NPR Extra Terms of Use Privacy Your Privacy Choices Text Only Sponsor Message Sponsor Message Become an NPR sponsor (function () { var loadPageJs = function () { (window.webpackJsonp=window.webpackJsonp||[]).push([[22],{310:function(e,n,o){o.p=NPR.serverVars.webpackPublicPath,Promise.all([o.e(1),o.e(2),o.e(3),o.e(4),o.e(80)]).then((e=>{o(15),o(769),o(155),o(176),o(93),o(447),o(254),o(128),o(130),o(754),o(175),o(755),o(255),o(78),o(773)}).bind(null,o)).catch(o.oe)},782:function(e,n,o){e.exports=o(310)}},[[782,0]]]); }; if (document.readyState === 'complete') { loadPageJs(); } else { window.addEventListener('load', function load() { window.removeEventListener('load', load, false); loadPageJs(); }); } })();
+ The rule would enforcement and accountability to a recently enacted law that requires hospitals to provide 120 days' notice before a labor-and-delivery closure.
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