Erin Maye Quade was telling a crowd of activists that this is the time Minnesota Democrats could build a better future for the state.

"Excuse me," she said, pausing suddenly and leaning on the lectern in front of her. She touched her stomach, pushing out a deep breath.

The candidate for a suburban state Senate seat was in active labor on the day of the competitive contest for the local DFL Party endorsement, eventually withdrawing to give birth. A video of the podium moment made national headlines, but it also reignited a biennial debate in Minnesota about whether the state's endorsement process and the wooing of the most devoted party activists has outlived its relevance.

"In recent years there has been a push to expand the diversity of delegates and bring new voices into this process," said Emma McBride, political director for Women Winning, which endorsed Maye Quade. "That's when these inequities and the lack of accessibility was revealed and has been really revealed more and more at each convention."

Each spring during an election year, Minnesota's political parties endorse candidates for local, legislative, congressional and statewide offices. While the results don't take the place of the August primary that's open to voters, candidates who fail to win endorsement can drop out before the primary filing deadline or leave their fate up to voters.

In some cases, the endorsement weighs heavily on the race. Republican-backed candidates for governor and other statewide offices nearly always prevail in primary elections in Minnesota, which has put more pressure on GOP candidates to appeal to party activists in the spring rather than focus on primary voters. On the DFL side, primary voters typically back legislative and congressional endorsed candidates, but they have rejected the DFL-endorsed candidates in open governor races dating back to the 1970s.

"Local delegates are a very narrow band of Minnesotans," said Iron Range state Sen. Tom Bakk, a former Democrat whose frustration with both parties prompted him to become an independent. "The delegates are out of touch with the greater electorate, [otherwise] their endorsed candidate would win the primary, and they don't."

Bakk said regular working people no longer attend endorsing conventions, which are held on weekends and draw activists who can devote hours to multiple rounds of balloting. A candidate must get at least 60% support to win the endorsement.

Last Saturday's local GOP convention in Minnesota's First Congressional District went past midnight. In the end, Republicans walked away without endorsing a candidate in the regular midterm contest as the race to replace the late GOP U.S. Rep. Jim Hagedorn through a separate special election grows more intense.

While state GOP Rep. Jeremy Munson didn't win the endorsement, he led in all seven rounds of voting.

"I don't just seek the party endorsement because I want to have some kind of seal of approval behind my name," Munson said. "I seek the party endorsement because it's the activists in the party that are most principled and they keep me true to my compass for being a Republican."

Some legislators want to bump up the state's August primary, in part to take pressure off the endorsement process. David Hann, the chairman of Minnesota's Republican Party, said in his role he's "agnostic" on whether to change the process, but he noted the benefit of campaigning for delegates' support.

"There's some people that would prefer that we went to a primary structure entirely," Hann said. "There's other people that really appreciate and value the endorsement process. There are people who are frustrated with the timing of the primary in conjunction with the endorsement."

Activists have favored endorsements as a way to limit intraparty fights and start campaigning against the other side as soon as possible. Party rules limit the fundraising and door-knocking activists can do without an endorsement.

DFL Party Chair Ken Martin said candidates such as former U.S. Sen. Paul Wellstone were able to win despite not having the most money or name recognition because they appealed to grassroots activists. That process has helped boost women and racially diverse candidates across the state.

"You don't see the great diversity in our state's elected officials, of both gender and also racial and ethnic diversity, without the grassroots," he said. "That is the true value of our caucus."

But he said changes should be made to the process, after the experience of Maye Quade, who gave her speech, then sat through a question-and-answer session and a first round of balloting while in labor.

The first ballot showed her trailing Justin Emmerich 55-44%. McBride said the campaign thought they had enough support to block an endorsement and head to the primary, but that strategy can require many hours of balloting.

Maye Quade asked Emmerich if he'd be willing to suspend the convention and go to a primary. In a statement, Emmerich said he was going to get back to her, but Maye Quade withdrew and left to go to the hospital. Emmerich was endorsed on the next ballot. Maye Quade is spending time with her newborn daughter Harriet and is still deciding if she will run in the August primary.

"Had there been a formal request from Erin or any of the delegates to suspend the convention in order to hold it at a later date, I would have agreed," Emmerich said, adding that he thinks the endorsement is the best strategy to keep the southern metro seat in DFL hands.

McBride and others said any medical emergency should have prompted immediate calls from leadership or others in the party to suspend or move the convention. That never happened.

"This process just, yet again, failed a woman of color," McBride said. "They argued their hands were tied because of rules and procedures, but people make rules and procedures and people can change them."

Martin said he plans to propose changes to DFL Party rules so it's simple to postpone a convention if a candidate has a medical emergency.

Staff writer Jessie Van Berkel contributed to this report.