Burcum: A city of 24,000 but nowhere to deliver a baby

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Minnesota health care faces significant financial challenges and historic staffing shortages. But as bad as those problems are, they don’t justify making women in labor drive through a snowstorm to deliver at a distant hospital.

Unfortunately, that is too often the result, with announcements about cutting and consolidating maternity care becoming regrettably routine. The Dec. 1 closure of Faribault’s birth center is just the latest example of this alarming trend across the state.

So what are our elected leaders going to do about it? Because throwing up our collective hands and accepting this shouldn’t be an option.

It’s disturbing that this vital care is often one of the first service lines to be consolidated at a facility in another community. The decision is typically touted as delivering more efficient and expert care. But there are trade-offs.

One of them is road tripping to a hospital, a dire prospect in a state known for its extreme weather. And let’s be clear that it is women who are expected to run this risk, something that infuriatingly conjures up medicine’s long history of minimizing female health needs and pain.

In addition to the new Faribault closure, my unofficial list of communities affected by maternity service cuts or relocations since 2021 includes Mayo Clinic Health System’s facilities in New Prague and Fairmont, Essentia Health in Fosston, Cambridge Medical Center, Granite Falls Health Center, Olivia Hospital and Regina Hospital in Hastings.

A state report released in November by the Minnesota Department of Health’s Office of Rural Health and Primary Care adds to the concern. It concluded that 18 Minnesota counties “have lost or reduced hospital birth services between 2013 and 2023.” The majority of these service losses are outside the metro.

If cuts and consolidation are the only way that Minnesota’s nonprofit health systems can make maternity care’s bottom line work, and that appears to be the case, then it’s time for policymakers to do something before maternity “care deserts” envelop the state.

I attended the public hearing Tuesday evening in Faribault about the closure of its hospital’s birth center and loss of several other service lines.

Metro-based Allina Health owns the hospital. Its local leaders spoke of the challenges of staffing around the clock and recruiting obstetricians. The combination necessitated consolidation of labor and delivery in Owatonna.

At the same time, Faribault is a city of about 24,000 people. This is not a small town in a far-flung corner of Minnesota. It’s shocking that families who live here will now have to go somewhere else to deliver a child. (Prenatal and postnatal care will be still be available here, though.)

Last year, there were 197 births at Faribault’s birth center. Expectant moms can now drive to birth centers in Owatonna, 14 miles down the road, or Northfield, 16 miles up the road. Another option outlined by officials at the hearing: M Health Fairview Ridges Hospital in Burnsville, a 34-mile drive.

If you scoff at the distance, I’m guessing you’ve never been in labor. It’s a stressful day, and the trip to the hospital shouldn’t add to that. There’s this reality, too: The second child (or third or fourth, etc.) often arrives with a much shorter labor. A delay of even a few additional minutes in the car matters.

Minnesota winters also shouldn’t be dismissed. An ordinary snowfall can cause challenging road conditions. A blizzard can make 10 miles feel like 100 as you creep along, hoping to see the road and stay on it. Nor is everyone fortunate enough to have a vehicle reliable enough to make this trip.

A grim acceptance seemed to settle over the lower-level meeting room at the Faribault Medical Center hearing Tuesday evening, with roughly 40 people in attendance. An energetic exception was Dr. Rose Marie Leslie, a family medicine physician who provides prenatal, birth and newborn care in Faribault.

“We deserve better than this ... than to have decreased access,” Leslie said, urging Minnesotans to lend their support to politicians willing to do something.

A state legislator heard her plea. Rep. Keith Allen, R-Kenyon, commendably came to the hearing on a cold night. He told the crowd of the weather challenges during his own children’s births and relayed his concerns about rural hospitals losing critical services.

In a follow-up interview, Allen clearly understood the urgency about maternity care losses and laid out one compelling path forward: providing more financial incentives to medical providers, particularly obstetricians, to practice in a rural area.

Rep. Robert Bierman, DFL-Apple Valley, who co-chairs an influential House health committee, said in an interview this week that he shared Allen’s concerns.

Bierman noted that federal cuts to the Medicaid program will make it more challenging to maintain maternity services in smaller communities. State lawmakers did take steps last year to improve public medical program reimbursements and expand midwife training, he said, adding that there’s much more to do and this needs to be a priority.