MaineHealth Removed as Defendant in Lawsuit, NPR Clarifies

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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 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 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). Elaine Appleton Grant hide caption Stay up to date with our Up First newsletter, for the news you need to start your day. DAMARISCOTTA, Maine — Artist Bailey Romaine, 37, was thrilled when she learned she was pregnant with her first child. 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. 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. 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. Shots - Health News She's trying to open a birth center near a maternity desert. It's not easy The potential closure is a worry for many in this rural region — and a rapidly growing problem around the country. When labor and delivery services aren't accessible, giving birth becomes riskier. 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. The Bristol, Maine couple is expecting their first child in January 2027. 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. "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. 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. Whatever happens with the closure vote Thursday, the group's leaders say they will not let this issue go. Their advocacy work has brought attention not only of this specific birthing center but of the maternity care crisis facing the entire state. 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. Leah Hurwitz's eight-month-old baby, Veda, sports a Miles Delivers sticker at a press conference in Damariscotta, Maine on July 24. Hurwitz had a dangerous breach birth that needed urgent care — she worries about risks to other parents should Miles be shut down. 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. Public Health Maternity care in rural areas is in crisis. Can more doulas help? Today, 60 percent of rural counties in America have no hospital-based birthing services, and closures aren't slowing down. 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. Miles Delivers is making the issue hard to ignore. The coalition was spun up practically overnight by three friends — local mom Margaret Reynolds, Moira "Rosie" Richards and Leslie Wolf. 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. "All these moms I had never met showed up at my front yard," Reynolds says. "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 weren't looking just to make noise. 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. "Instead of assuming closure was inevitable, we started looking for other ways forward," Reynolds says. 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. "Almost immediately, people started coming to us from inside," Reynolds says. "We had their own board members come to us. We had their providers come to us in droves. We had donors come to us. We had people saying they're not listening to us. Do anything you can." Rural obstetrics departments lose money. Nationally, birth rates are declining and OB/gyns are in short supply. 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 they've been fighting what they call a lack of transparency on MaineHealth's part. From the start, they set out to understand the facts underneath the organization's arguments – which included money. "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. 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. It relies heavily on temporary ob/gyns. 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. Andy Mueller. 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. MaineHealth's reception to the coalition's ideas has been lukewarm. 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. But the coalition points out that for many people, drive times would be an hour or more — especially with tourist traffic or bad weather. Longtime Miles family physician Tim Goltz is worried. "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 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. 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. Sponsor Message Become an NPR sponsor