June 1, Lincoln County residents and local politicians filled the Boothbay Region Elementary School gym to protest the possible closure of labor and delivery (obstetrics) services at Lincoln Hospital (Miles) in Damariscotta.
The public forum was hosted by MaineHealth. A board of healthcare professionals was present: LincolnHealth President Cindy Wade, Lincoln Hospital Board Chair Bruce Garren, Coastal Region Chief Nursing Officer Christine Anderson, Chief Medical Officer Tim Fox and Senior Director of Physician Aiding Services Andy Russ.
According to Wade and a meeting handout, the review is not financially motivated, but due to staff recruiting challenges and low birth volume. Based on data from the past three years, the average is 130 births per year. This low number is attributed to the county’s older population and the fact that seven out of 10 expectant mothers in the county chose to deliver at other hospitals. More women are waiting to have children, and older women are more likely to have multiples or otherwise complex pregnancies, and so tend to go to larger hospitals, said Wade.
As for staff recruitment, candidates do not want to be on call for multiple evenings a week to cover after-hours care. OB/GYNs also want to be busy, and younger providers tend to prefer areas with higher birth volume to get experience. As such, the hospital has not had a full-time OB/GYN since 2020, resulting in contracted providers, which doesn't allow for care consistency, according to the handout.
If there were a closure, MaineHealth data analysis shows that the average drive time for patients would increase by 18 minutes to get to another birth center. Wade acknowledged the estimate could be impacted by bad weather or summer tourism. She said the hospital would continue to provide prenatal, postnatal and all-age gynecological services. She also assured that if the obstetrics department closed, the rest of the hospital would not follow suit.
There was then a chance for the public to share opinions. Many offered anecdotes of the expert obstetric care at Lincoln Hospital. According to the LincolnHealth website, the hospital was the first in Maine and the fifth in the nation to be designated Baby Friendly by the World Health Organization (WHO). Many speakers noted this and questioned why the department would be shut down, and not uplifted as an example.
Margaret Reynolds of Damariscotta, a member of Miles Delivers Action Coalition, said Miles helped heal trauma from delivering her first child in Louisiana, and how the department's closure would contribute to higher infant mortality rates and high expense for families who may be forced to have their babies in ambulances or emergency rooms. She urged LincolnHealth to look for solutions, pointing to the recent $190 million funding from the federal Rural Health Transformation program.
“I recognize that there are real concerns involving staffing, but workforce shortages are exactly the kind of challenge that public investment is intended to solve. They are not a reason to eliminate services, they're a problem looking for a solution,” she said.
Worries about travel time and the possibility of delivering in ambulances or emergency rooms were among the most common concerns. Moira Rose Richards of New Harbor called the prospect “terrifying” and questioned what training emergency medical technicians (EMTs) have to handle ambulance deliveries.
“When (these women) are the most vulnerable they will ever be in their whole life, they ask for a safe space. That's what they're asking for. You can't give them that in an ambulance, you can't give them that in a lot of places, you can't give them that in a big, big hospital,” said Andy Baron, former Lincoln Hospital labor and delivery nurse. Baron also spoke on the long-term consequences of a traumatic birth on both mother and child, and how, in the absence of places like Miles, some would rather deliver at home than in a larger hospital.
Gubernatorial candidate Troy Jackson of Allagash shared a personal experience of the long travel his laboring wife experienced trying to get to a birth center, and how the closure of obstetrics has impacted Aroostook County. Other politicians in attendance were State Representatives Holly Stover and Wayne Farrin and candidate Charlotte Nutt, State Sen. Cameron Reny, and Maine Secretary of State and gubernatorial candidate Shenna Bellows.
“The birthing center closures across the state feels emblematic of a larger trend of creating a state that is wonderful to vacation and retire but not wonderful for the next generation to grow in,” said Bellows.
Other audience members shared the sentiment, saying the lack of birth centers would only discourage young people from moving to the area or trying to start families, exacerbating both the state and county’s high senior population.
Boothbay Region Elementary School custodian Tom Dewey of Boothbay Harbor said, “It's just the beginning of the end. There are two ways, in my opinion, to kill a town: Lose a school (or) lose the ability for people to start going to the hospital in their local area.”
Residents can send more feedback to lincolnfeedback@mainehealth.org. The assessment is expected to be completed by the end of June, and no official decisions made until at least August.