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Emily Young is a family physician and member of the Maine Academy of Family Physicians who lives in Farmington and practices in Franklin and Kennebec counties.
My second child was accidentally born at home. It was 3 a.m. during a Montana ice storm and labor progressed faster than expected. I was lucky: I am a family medicine physician who delivers babies and cares for newborns, as was my own doctor, a close friend. Our calls to her that night rapidly transitioned from, “We’re heading to the hospital,” to, “Come to the house! The baby is coming!”
Luckily, my son breathed on his own and my bleeding was normal. After she stabilized us both, we made a slow two-mile icy drive to our hospital, equipped with doctors and nurses trained in birth emergencies, who whisked us inside and kept us warm and safe. But what if we had over an hour-long cold, icy drive?
That risk of distance faces more and more families across rural Maine. MaineHealth is considering closing the labor and delivery unit at Lincoln Hospital in Damariscotta. If it closes, that would make Lincoln the twelfth Maine hospital to end birthing services over the last decade, and the fifth since the start of 2025 alone. We are building what are known as maternity care deserts: communities where the nearest place to safely deliver a baby is an hour or more away.
Distance is not a minor inconvenience in childbirth; it is a medical risk. Mothers already die more often in rural areas than in cities. One study found that from 2011 to 2016, the maternal mortality rate was 24 deaths per 100,000 births among women in rural America, compared with 20 in cities. The farther a woman must drive, the less prenatal care she typically gets, which leads to worse outcomes for both mother and baby. One study of rural hospitals found that when family physicians stop delivering, patients face an extra 86 miles of round-trip travel to reach care. My own hospital was two miles away the night my son was born. Had anything gone wrong, each mile would have been critical.
Today, I am a family medicine doctor in Franklin County who staffs our critical access hospital emergency department. I also work as a hospitalist, deliver babies, and care for newborns in Kennebec County. I live and practice here because I am able to use my full skill set.
When a birthing unit closes, the family doctors who staffed it often leave for places where they can use their full skills, and they take primary care with them. Maine has watched this happen after closures on Mount Desert Island, Fort Kent, Rumford, and Lincoln.
Keeping rural labor and delivery units open is a hard problem, but it is not unsolvable. “Too expensive and too hard to staff,” is not an answer rural families can live with. We can fund critical access hospitals to keep units open, improve pay and loan repayment for physicians and nurses who staff them, make malpractice coverage affordable, and expand obstetric training within Maine, including cesarean training for family physicians.
Once a birthing unit closes, it almost never reopens. If we keep closing them, the pattern is predictable: clinicians leave, families get less care, maternal deaths climb, and young people stop putting down roots. The question in rural Maine should not be whether to keep delivering babies, it should be how.