why this matters
Obstetrical and newborn care in Maine is changing quickly.
Birthing units have closed across the state, and each closure has effects that reach well beyond the community losing the service. Patients are traveling farther for care. Emergency departments and EMS in communities without birthing units need to be prepared for obstetrical and neonatal emergencies. And the birthing units that remain are caring for more patients, placing additional demands on staff, beds, operating rooms, nurseries and other infrastructure that may not have been designed for these increased numbers.
This isn’t simply a rural hospital problem. It is changing how obstetrical and newborn care works across Maine.
And Maine is not alone. Communities across the country are facing many of the same challenges.
there is a lot of good work happening
There are already important efforts underway in Maine.
Through the federal Transforming Maternal Health (TMaH) Model, work is underway to improve maternal health and develop stronger regional partnerships and approaches to care. https://www.maine.gov/dhhs/oms/about-us/tmah-model
At the same time, Maine’s Rural Health Transformation Program is looking much more broadly at how to strengthen access to health care in rural communities. This work isn’t specific to obstetrical and newborn care, but the investments and new approaches that come from it could have important implications for how pregnancy, birth, postpartum and newborn care are provided in rural Maine. https://www.maine.gov/dhhs/ruralhealth
Other work is happening around obstetrical and neonatal emergency training and simulation, maternal and newborn safety, telehealth, transfers between hospitals, and support for clinicians who may find themselves caring for pregnant patients or newborns when specialty services aren’t immediately available.
We also have the opportunity to learn from other states that are facing many of the same challenges and trying different approaches.
But physicians need to be part of the conversation
For the most part, the voices of practicing physicians have been surprisingly limited in many of these conversations.
That matters. The changes happening in obstetrical and newborn care affect far more than labor and delivery units. They affect OB/GYNs, family physicians, pediatricians, emergency physicians, anesthesiologists and others caring for pregnant patients, newborns and families—both in communities that have lost birthing services and in the hospitals taking on more patients as a result.
We don’t pretend to have all the answers. But we do believe that the people caring for these patients every day should have a meaningful voice in figuring out what comes next.