Labor Pains: As delivery wards disappear, is rural Maine becoming a 'maternity desert'?
BELFAST, Maine (WGME) -- Expecting a baby comes with a lot of unknowns and for moms in rural Maine, that now includes figuring out where to give birth.
More hospitals are shutting down their maternity wards, leaving some families close to an hour from the nearest delivery room.
It's one of the biggest moments of their lives. Aluna and Peter Kazickas are expecting their first child, due March 23.
"I'm hoping I hit the 39 week mark and she's ready," said Aluna as she looked at her belly.
If their baby arrives on time, they’ll be among the last to deliver at MaineHealth Waldo Hospital in Belfast. Its delivery unit closes permanently on April 1.
“Labor as long as you can at home, and then hop in the car and you're five minutes away,” Aluna Kazickas said as she recalled her coaching with the midwives.
But if their baby comes even a week late, that five-minute drive to the hospital will turn into nearly 40 minutes. MaineHealth Pen Bay Medical Center in Rockport becomes the next closest option.
Waldo’s closure marks a growing trend in Maine. The I-Team found that nine hospitals in the state have shut down labor and delivery wards in the past decade, with staffing shortages and low birthrates cited as the main reasons.
A list of Maine hospitals that recently closed/closing labor and delivery units:
- Penobscot Valley (2014)
- Calais Community Hospital (2017)
- Bridgton Hospital (2021)
- St. Mary’s Regional Medical Center (2022)
- York Hospital (2023)
- Northern Maine Medical Center, (2023)
- Rumford (2023)
- Northern Light Inland Hospital (March 1, 2025)
- MaineHealth Waldo Hospital (April 1, 2025)
A list of the remaining maternity wards in Maine (as of April 1, 2025):
- Cary Medical Center
- Central Maine Medical Center
- Down East Community Hospital
- MaineHealth Franklin Memorial Hospital
- Houlton Regional Hospital
- MaineHealth Lincoln - Miles Campus
- Maine General Medical Center - Alfond
- MaineHealth Maine Medical Center Portland
- Mid Coast Hospital
- Mount Desert Island Hospital
- Northern Light AR Gould Hospital
- Northern Light Eastern Maine Medical Center
- Northern Light Maine Coast Hospital
- Northern Light Mayo Hospital
- Northern Light Mercy Hospital
- Penobscot Bay Medical Center
- Redington-Fairview General Hospital
- MaineHealth Maine Medical Center Biddeford
- MaineHealth Stephens Memorial Hospital
Babies few and far between
“We were facing nurse staffing shortages,” said Denise Needham, president of MaineHealth’s Pen Bay and Waldo hospitals. She noted that Waldo’s labor and delivery unit averaged only about 100 births per year, making staff recruitment difficult.
“More days than not, you're not delivering babies,” Needham said.
Experts tracking the decline in maternity services warn that the impact of these closures extends beyond simple inconvenience. Ashley Stoneburner, director of applied research for March of Dimes, studies “maternity deserts” across the country—areas where no birthing hospitals or obstetric care providers are available.
“It is important to know that there are a lot of ways to define access. And the experience of feeling a lack of access is an issue,” Stoneburner said.
Under March of Dimes’ definition, Waldo County could become Maine’s first maternity desert when Waldo General closes its delivery unit in April.
“Research tells us that in communities after hospitals have closed, especially in rural areas, there's more out-of-hospital births that occur. There's more births that occur in emergency rooms, in hospitals where possibly doctors are not equipped to handle obstetric emergencies,” Stoneburner said.
MaineHealth argues it is avoiding a full-fledged maternity desert by keeping prenatal and postnatal care available at Waldo General, even though labor and delivery services are ending.
“Usually what you'll see is when a program pulls their labor and delivery service, they'll pull all of the pre- and post-natal care out of the community. That's when you really see those bad outcomes,” Needham said.
- For the full March of Dimes report specific to Maine, read here.
More closures on the horizon?
Inland Hospital in Waterville is also shutting down its maternity services. Northern Light Health announced it will “pause” deliveries there starting March 1.
“We delivered 229 babies last year,” said Marie Vienneau, senior vice president at Northern Light Health.
Despite that volume, Vienneau said the hospital couldn’t recruit enough OB/GYNs.
“You don't want to close your labor and delivery unit,” she said. “I can tell you that most hospitals that provide these services think about it and talk about it every day.”
The roughly 200 expectant mothers who planned to deliver at Inland are now being directed 20 minutes south to MaineGeneral in Augusta, which already handles about 1,200 births per year.
“Babies are great. It's one of the more positive things we do in healthcare,” Vienneau said. “But it's also an extremely resource-intensive service.”
Delivering a financial burden
Harold Miller, president of the Center for Healthcare Quality and Payment Reform, said hospital closures largely come down to money.
“There are hospitals, rural hospitals around the country that maintain labor and delivery services with a very small number of births,” Miller said.
He estimates rural hospitals lose upwards of $20,000 per birth due to low insurance reimbursements.
“The hospital typically only gets paid for each birth that it has. So, the fewer the births, the less revenue they have to maintain those staff,” he said.
Larger health systems, Miller explained, often redirect resources toward more profitable services, such as cancer treatment.
“Many hospitals traditionally have subsidized labor and delivery services with the profits they make on other services,” Miller said.
Needham confirmed oncology is expanding at MaineHealth as maternity services shrink.
“Sadly, oncology is an area of huge growth for us and we're expanding those services all the time. And you really have to weigh, where do we invest, where are we meeting the needs of the community, and where do we need to reconsider adjusting?” Needham said.
Miller believes restructuring staffing models and payment systems could keep maternity services viable in rural areas. He advocates for hospitals to employ more family doctors rather than specialists and for insurance plans to reimburse rural hospitals not just per delivery, but for the overall cost of keeping maternity care available.
- To read more on Miller's cost analysis, head here.
What's next for rural moms?
Maine has one of the highest home birth rates in the country, at 2.8%, and midwives in rural areas say they expect more families to consider giving birth at home rather than turning to unfamiliar providers.
For Kazickas, the biggest concern is the length of the trip when the time comes.
"The discomfort... That's actually the thing I've been thinking about the most.. Being in active labor in a car is not a fun experience,” she said. “And minimizing that time is really great.”
In response to growing concerns, U.S. Sen. Susan Collins is sponsoring a bill that would train EMS for emergency deliveries, provide telehealth access to obstetricians, and keep essential birthing equipment in closed hospitals for emergencies.
