Candlelight Vigil for MDI Hospital OB Closure

The Bar Harbor Story is generously sponsored by Paradis Ace Hardware.

BAR HARBOR—A group of OB nurses and other concerned citizens gathered at the Bar Harbor Village Green Monday evening to commemorate the loss of the island’s maternity unit and to also promise to keep working toward getting an obstetrics department back on Mount Desert Island.

“I am never going to give up on the dream that it is possible. We did it. So we know it’s possible and, yes, I’m heartbroken,” said Fulbright grantee, author, and retired nurse midwife Linda Robinson. Her remarks were referring to the community’s past efforts about getting maternity services on the island and other women’s health needs as well as her hopes to get a hospital OB maternity ward again.

Robinson said to the group of approximately forty people gathered before the town’s bandstand, “This is way, way more than a financial or a faux-safety decision. I will forever describe this as a human rights abuse. This is just criminal that we are denying care to the women in this community. It is possible to continue this service, but they have chosen not to.”

Mount Desert Island Hospital announced in March that it would close its obstetrics department, a closure that begins today, July 1. The hospital has explained that its decision is due to multiple factors including worries about losing certification because the OB services do not see enough patients each year, which can cause issues with insurance and patient safety.

“Critically, with so few births, our nurses and providers cannot maintain the necessary skills and experience required for safe deliveries. Patient safety is our top concern and ensuring that our staff can provide the highest level of care means making this difficult decision,” the hospital wrote on its facts page.

Mount Desert Island Hospital joins nine other hospitals who have ended their birthing units in the past ten years. Many of those closures occurred in the past year. There are now less than 20 birthing units in hospitals throughout the state.

Mount Desert Island is not alone in the decreasing number of births. Maine’s fertility rate is 49.7 births per 1,000 women 15 to 44 years old, according to the Centers for Disease Control and Prevention.

In 2023 the country’s provisional general fertility rate “was 54.4 births per 1,000 females ages 15–44, according to a report by the CDC.

The National Center for Health Statistics wrote in April 2024 that “the general fertility rate in the United States decreased by 3% from 2022, reaching a historic low. This marks the second consecutive year of decline, following a brief 1% increase from 2020 to 2021. From 2014 to 2020, the rate consistently decreased by 2% annually.”

“This is deeply personal for me; I gave birth to both of my children here,” MDI Hospital President and CEO Christina Maguire said in a statement. “We know how much this service has meant to our community. But we must adapt to ensure the continued strength of our hospital and the care we provide. This decision, while painful, is necessary to ensure the sustainability of high-quality healthcare services for all.”

Declining birth rates were cited as a reason for the choice, which comes as the hospital is in the beginning of multi-year, multi-million dollar expansion plans, which call for a doubling of emergency room space.

“Although our closure is in effect at midnight tonight. We have not given up. As Linda said, we are gonna go. Our task force is in action now to continue the hope of reversing the closure and to bring the transparency that we’ve been asking for since the very beginning,“ Janice Horton, RN, a 32-year veteran of MDIH’s OB department said on Monday.

Advocates for continuing the OB services say that there was no community involvement in the decision and that there could have been problem-solving efforts to keep delivering babies at the rural hospital.

“We are always really good at problem solving,” Robinson told the crowd.

“That’s what we have to do now. I don’t want to believe this is the end. We are faced with a problem,” she said, and now they have to figure out how to go on.

Since the hospital’s decision, the OB nurses and others have protested, held community gatherings, and circulated a petition against the closure. The hospital has put out a fact sheet on its website as well as sent a letter about disciplinary measures for the nurses involved in a May protest against the decision. It hosted a session at the Jesup Memorial Library where people spoke about the closure. It spoke to some of that discussion later via its facts page.

But on Monday night, the gathering was focused on loss and the hope that the service will someday return. One nurse read a poem she wrote entitled “The Care That Remains.”

“In this quiet place by the sea,” the poem begins, “has born witness to beginnings and held the weight of so many precious persons. We have been the hands that caught life as it arrived in the hush before sunrise, in the middle of storms, in the roads where deer stood frozen.”

The poem spoke to the maternity department’s culture of listening, of honoring patient voices, and of compassion and not just care.

“Together we became more than a team, we became a lifeline,” the poem reads.

Others spoke to their own birthing experiences and the start of the women’s health center in 1992.

“Everyone said if you want to have a baby, come to Bar Harbor,” one woman said.

Horton, like other speakers, tried to inspire and celebrate the nurse’s past efforts.

“We proved time and time again what it meant to be a dynamic team and not just coworkers,” said Horton, one of the last speakers. “It is a wonderful feeling to welcome a new life into the world.”

“We were part of something bigger than ourselves. We were part of those life changing moments for our new families. We were safe confident and 100 percent there for you,” Horton said.

According to a representative from the nursing union, all but one of the nurses have lost their jobs at the hospital.

A hospital spokesperson said Tuesday morning, “All affected employees were separately offered and encouraged to apply for additional employment opportunities within the organization which they are qualified for. And while we can't detail who sought employment and who did not, what we can tell you is we are very excited to have one of our OB nurses who accepted the position as the Women's Health Navigator Nurse, stewarding the future of maternal health on this island. As she settles into her role, we will have more information to share, and we are excited to do so.”

The hospital has said in an earlier press release that it intends to:

• “Double the size of the emergency department through a grant and donor-funded renovation. One of the new rooms will be equipped with labor and delivery equipment for emergency births.

• “Continue coordinating with nearby facilities to ensure smooth transfers for deliveries.

• “Have MDI Hospital’s emergency care staff rotate through partner hospitals to maintain their labor and delivery skills.

• “Explore a women’s health patient navigator program to guide expectant mothers through prenatal, delivery, and postpartum care—offering personalized support and care coordination.”

According to a February 2024 white paper by Hailey Bondman and Alexandra Zimmerman, “A majority of rural births occur at local facilities, yet more than half of rural counties no longer have access to obstetric (OB) services. Studies show a doubling of infant mortality rates where counties have lost OB services. Additionally, out-of-hospital births and preterm births increase in counties without hospital-based OB services. Recent changes in the maternal health landscape have the potential to exacerbate the preexisting disparities in rural maternal health related to the availability of the maternal health workforce, maternity care coverage policies, and the provision of equitable access to maternal care services.”

There will be fewer than 20 birthing units open in Maine after this summer. Eight have closed in the past ten years, including Blue Hill Memorial Hospital. There is still an option to have a hospital birth at Northern Light Maine Coast Memorial Hospital, but for emergency situations, seamless prenatal and post natal care, that worried Emily Wright, RN, a primary obstetric nurse, and others.

According to the American Legal Journal, “Maternity wing closures also create several pressing health equity concerns. Many women who are giving birth have no choice but drive more than 40 minutes to get to maternity care due to the shortage of providers and facilities. Some pregnant women are temporarily moving to be closer to the maternity provider. Temporary relocation is something that not everyone can afford. Geographic isolation from comprehensive health care increases the risk for complications and death. Many low-income women who are pregnant do not have the financial or reliable resources to travel long distances.”

The hospital’s release stated Maguire “emphasized that the closure does not reflect a diminished commitment to maternal health. Instead, it reflects harsh realities: skyrocketing costs, a shrinking rural population, and inadequate reimbursement from federal and state sources.”

The hospital later said those skyrocketing costs refer to the increased cost of living and basic necessities.

The vigil Monday night ended with hugs and a group photo of the staff others before people quietly walked away.

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Photos: Carrie Jones/Bar Harbor Story.

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LINKS TO LEARN MORE

“Protect Our Patients”

Direct link to view and/or sign the petition

Hospital’s FAQ page

Hospital OB Nurses Rally Community & Urge People to Sign Petition To Keep Maternity Wing Open

MDI Hospital Will Stop Delivering Babies July 1

Local Nurse Speaks Out as Hospital Plans Maternity Unit Closure

Maternity Services Dwindle: Nine Maine Hospitals Close or Announce Closures in Ten Years

As Birthing Units Close, Where Do Midwives Fit In?

To read the hospital’s original press release.

To read the nurse’s union original press release.

The hospital’s website.

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