Editor’s note: This story contains details about pregnancy loss that may be upsetting to some readers.
RUMFORD, Maine — Lia Cameron can see Rumford Hospital from her front window. But that didn’t help during her recent pregnancies.
The hospital’s birthing center closed in 2023.
Instead, she drove an hour each way to deliver her children and receive prenatal and postpartum care.
“It would have been so much easier to make my appointments if I could have gone to Rumford Hospital. It would have been like ‘OK, I need to go. I’ll be back soon,’” said Cameron, pretending to wave goodbye to her family.
The reality was a lot less convenient — and dangerous.
Longer drives for maternity care are becoming increasingly common in Maine.
Almost half of the state’s birthing centers have closed since 2015, and MaineHealth Lincoln Hospital in Damariscotta will become the 12th when it ends labor and delivery on Dec. 18. Only 14 remain.
Maine has the second-highest rate of rural maternity ward closures in the United States, according to a July analysis by the Center for Healthcare Quality and Payment Reform, a Virginia-based health policy think tank. Since 2020, 37% of the state’s rural hospitals have shuttered their maternity wards. That’s second only to West Virginia, at 40%.
Nationally, 146 maternity wards have closed in rural hospitals since 2020, a 14% decline, according to the center.
Cameron, in Rumford, said she’s considered “high-risk” ever since she had a stillborn baby, Owen, in 2022. She has an irregular heartbeat, anemia and has had problems with bleeding too much during her pregnancies, so she worries about going into labor during the car ride and delivering on the side of the road if she gets pregnant again.
Her closest options for maternity care are in Norway and Farmington.
“There’s a lot of times I avoided going to the hospital because of how far away it was,” said Cameron, 25.
Her fiancé, Wyatt Inglis, 27, said there’s much that goes into getting ready for the appointments.
“It’s not just the hour drive. It takes an hour to get ready to go, to arrange for childcare, to feed the kids,” Inglis said. “We can’t just get in the car and go.”
Then if it’s winter, there’s dealing with icy and snowy roads, adding time and danger to the journey.
Cameron’s children from a previous relationship — Skye, 2, and Sean, 1 — were born at MaineHealth Stephens Memorial Hospital in Norway, so she’s spent a lot of time traveling — two hours round trip, as often as four times per week — for doctor’s appointments.
This year, Cameron was pregnant when she and Inglis were told “devastating” news in June – their 16-week fetus had died in her uterus.
They had to drive home from the hospital, make arrangements and return shortly after for an induced labor.
“We heard the news, and we were crying the whole car ride home,” Inglis said. “We made sure the kids were fed, spent an hour at home getting everything ready, and had to turn around and go back to the hospital.”
Cameron said, “we had to drive four hours when my baby died.”
They named her Rosalie.
The couple is considering having another baby. But they’re worried about going through all of that again. The long drives. The heartbreak.
“We’ve been thinking about trying again, but is it the smart thing to do?” Inglis said.
Cameron said she thinks about how much she bled when she was delivering Sean in 2025 and how dangerous it would have been for her and her baby if she had to stop and give birth during the drive to the hospital. Sean also had difficulty breathing when he was born, she said.
“The distance is a lot and the stress is a lot,” said Cameron.
‘Everything is closing’
Rumford is similar to many rural towns in Maine — it’s struggling to maintain services with a flat or declining population. The local paper mill employs about 500 workers, down from thousands decades ago.
“Anyone our age has moved away or wants to,” said Cameron, who sells homemade crafts.
Inglis, who has worked as a deli manager, listed businesses that have closed in the last 10-15 years: a landmark restaurant, a bowling alley and a movie theater. Rumford’s population has dropped from about 6,700 in 2000 to 5,800 in 2020, according to the U.S. Census.
“High school football games — that’s the only thing the community has going on anymore,” Inglis said.
Johanna Palmer, 53, of Rumford, was sitting underneath the awning of the vacant House of Pizza on a warm and sunny September afternoon, near other shuttered businesses downtown.
“Everything is closing down,” Palmer said. She said “there’s a whole lot of people who were upset” when the local hospital shuttered its birthing center, and it makes it harder to attract young people to move to the town.
“It puts the baby and mom at risk,” Palmer said. “We don’t have a lot of resources here anymore.”
Cameron said she wasn’t surprised when labor and delivery closed, but it was “kind of depressing.”
“It’s disappointing. There’s a lot of people in town who are pregnant and don’t drive,” Cameron said, which complicates the birth even more.
Olivia Pennington, associate vice president of public affairs at Maine Family Planning, said that while the organization’s Rumford clinic provides reproductive services, including pregnancy confirmation testing, it doesn’t have prenatal services. They are seeing the impact of the lack of available care.
“We have no local place to refer our patients to for prenatal and OB/GYN care,” Pennington said. “It’s incredibly clear there’s enormous barriers to reproductive health in rural Maine.”
Closures across Maine
The median drive to a maternity ward in Maine is 45 minutes, compared to 36 minutes for the U.S. overall, according to the Center for Healthcare Quality and Payment reform.
Brittni Frederiksen, associate director for Women’s Health Policy at KFF, a national health policy think tank, said in an interview that there are many reasons why maternity wards are closing.
“People are moving out of rural areas, which makes it difficult for hospitals to hire providers who want to work in rural areas because of the low numbers of births,” Frederiksen said.
Low birth volumes and difficulties attracting obstetricians and midwives were the main reasons cited by hospital officials for shuttering the Lincoln Hospital birthing center in Damariscotta.
Births have declined in Maine, going from about 14,000 annually in the 2000s, to about 12,000 per year in recent years, according to state data. Birth rates have also declined nationally, but Maine typically has fewer births per capita compared to the national average. In 2024, the most recent year national data was available, Maine had the sixth-lowest fertility rate, according to the U.S. Centers for Disease Control and Prevention.
Frederiksen said rural hospitals are more likely to serve lower-income patients, so a higher percentage of patients having babies would use Medicaid as their insurance. Medicaid reimburses at a lower rate than private insurance and does not cover the cost of delivery. The financial losses make it difficult for rural hospitals to maintain services, she said.
“We already have a maternal health crisis,” Frederiksen said. “Increasing the distance to care will lead to more poor outcomes.”
Dr. Rose Fuchs is an independent family practitioner in Patten, a town with less than 1,000 people. Fuchs delivers babies, and she said she’s seen the impact of Houlton Regional Hospital shuttering labor and delivery in 2025.
“Most deliveries are normal, but when something happens it can be catastrophic,” Fuchs said. “Bleeding problems are very real for mothers right at delivery. Breathing difficulties with the baby are very common.”
Fuchs said births are unpredictable, and mothers often show up at the hospital who are not yet ready to deliver.
“If the hospital tells you, ‘Go home, it’s too early,’ well, that can be a pretty long time,” Fuchs said.
The Lincoln Hospital closure touched off a community uproar and statewide discussion looking for solutions. A grassroots group, Miles Delivers Action Coalition, held rallies, put together position papers and urged MaineHealth to keep the center open or delay its decision.
Suggestions included allowing more practitioners, such as family physicians, to deliver babies and increasing financial incentives for obstetricians and midwives to practice in rural Maine. Some also advocate for boosting Medicaid reimbursement rates for labor and delivery.
Gov. Janet Mills and all three major gubernatorial candidates — Democrat Hannah Pingree, Republican Bobby Charles and independent Rick Bennett — urged MaineHealth to delay the decision, to no avail. Pingree has said if elected she will put together a task force on the topic, and a legislative committee held a hearing on the issue this summer.
Long drives, gas prices and tourist traffic
Emma White, 27, of Baileyville, said she lives over an hour away from the closest hospital with a maternity ward, Down East Community Hospital in Machias. The closest hospital to her home, Calais Community Hospital, closed its birthing center in 2017.
White said when she was pregnant in 2025, she chose to drive even farther, to Bangor, because it has a much larger birthing center and a neonatal intensive care unit.
“I was so nervous about mis-timing the birth and having the baby in the middle of nowhere,” White said. “When I realized I was going to have my baby girl in February, I thought ‘Oh my God, this could not be worse timing.’”
White said her water broke at 3 a.m., and it was a nearly two-hour drive to Bangor, much of it on Route 9, a windy, two-lane highway. She gave birth on Feb. 20 to a baby girl without any complications, but it was a close call.
“Two days after I went home, there was a huge storm with 10 inches of snow, and it would not have been safe to travel in those conditions,” White said.
She had contingency plans for winter storms, such as staying in a hotel in Bangor, but said it would have been difficult to time without knowing what day or week she would go into labor.
Leanne Dunham, a doula who practices in Washington County, said aside from the dangers to mom and baby when the hospital is far away, there are practical problems too.
Trying to arrange care for older children when there’s a childcare shortage and having to take extended time off of work are common barriers. Dunham said prenatal appointments in the third trimester are typically weekly and can take an hour or longer.
“You add long drives on top of that and it’s pretty impactful,” Dunham said. “It’s not unusual for my patients to weigh the cost of gas to go to an appointment, and heating their home.”
Drive times can also be lengthened during tourist season.
When Mount Desert Island Hospital in Bar Harbor closed its maternity ward in 2025, getting to the next closest hospital in Ellsworth got more complicated.
“There’s one road in and one road out,” to the island where Acadia National Park, one of the country’s most popular parks, is located, said Erin Oberson, a nurse who worked per diem at the Bar Harbor hospital before it closed its birthing center. “If there’s a bad accident, that road can be shut down for hours.”
Oberson said missing prenatal appointments can be damaging to a mom’s and infant’s health. Something as simple as screening for sexually transmitted infections can help prevent birth defects, she said. Treatable conditions like gestational diabetes or hypertension can be taken care of during prenatal appointments.
“It’s super important, but it’s not like moms want to miss their appointments,” said Oberson, who works in labor and delivery at Northern Light Eastern Maine Medical Center in Bangor. “It’s just becoming logistically impossible.”
This story was originally published by the Maine Trust for Local News. Joe Lawlor can be reached at jlawlor@pressherald.com.