The MaineHealth board has voted to end labor and delivery at Lincoln Hospital in Damariscotta, moving care to Mid Coast Hospital in Brunswick by mid-December. This is the 12th hospital birthing unit Maine has lost since 2015. Though it’s a product of their terrible policies, Augusta Democrats would prefer you blame a nonprofit hospital system’s “corporate greed.”
As a mom of five, I keep thinking about what that means for rural families. Does an expectant mother leave home near full term so she is closer to a delivery unit? How does she manage that with other little kids still at home? Or does she plan to drive an hour or more in active labor and hope she makes it?
I have ridden out contractions in a car. I would not choose an hour of that on a winter road.
When I think about rural moms in Maine who may have to deal with that, I am sad, frustrated, and angry at the choices that brought us here.
MaineHealth laid out the math the day before the board vote in a letter to lawmakers. Lincoln hospital averages about 130 deliveries a year, very low by national standards. The hospital has carried an open OB-GYN position for five years. Candidates walked away over call burden, volume too thin for board-certification pathways, and the requirement to stay near the hospital on call nights. Coverage has depended on voluntary per diems and extraordinary stretches by leaders. The unit went on diversion (a temporary closure) three times in six months. In one case, a patient in labor waited in the parking lot for a provider to start a shift.
This is all from the hospital board’s own record.
As the story moved through the news, people on both sides of the aisle, including candidate for governor Hannah Pingree, called for the unit to stay open. An expectant mother sued to stop the board vote; the emergency injunction failed. Protesting, suing, or asking nicely does not staff a night shift when the clinicians don’t exist!
Twelve rural birthing units did not vanish because of one board meeting or one bill. They closed after years of thin volume, failed recruitment, and policy choices in Augusta that ignored what rural hospitals actually need to keep a 24/7 obstetrics team running.
It is easy to blame Washington for everything that hurts, but Maine is one state out of fifty. We share a president with every other state, and access to care still varies sharply from state to state. The government closest to us shapes those differences. Democrats have held the majority in the Maine House for 48 of the last 50 years. That record matters when we talk about why rural service lines keep failing.
Start with workforce. When Governor Mills mandated COVID shots for health care workers, many left the bedside. Some never returned after the mandate was lifted. A 2019 law pushed by Democrats stripped religious and philosophical exemptions tied to immunization rules for health care workers and others. Every year I still hear from nursing students who learn about that law and start planning their careers somewhere else.
Then look at market design. Maine’s Certificate of Need laws make it harder to expand capacity and easier for incumbents to block competition. The Federal Trade Commission and the Justice Department’s Antitrust Division have long treated CON regimes as barriers that restrict patient choice and raise costs. Augusta Democrats have refused repeal, session after session.
Payment design compounds the pressure. One of Governor Mills’ first acts was implementing MaineCare expansion for working-age adults who would not have qualified under the older categories of children, seniors, and people with disabilities. Today, that portion covers more than 80,000 able-bodied, working-age adults without children.
MaineCare pays well below the full cost of care, and that simply cannot fund a round-the-clock labor team. Low-volume rural units like Lincoln Hospital feel that gap first. Health systems then recover margin where they still can, on premiums and patient charges for consumers on private insurance premiums and patient charges. Families on employer coverage pay more. Families in Lincoln County drive farther when the unit finally breaks.
Outside the hospital walls, the recruitment problem gets worse. Maine now carries a top income tax rate of 9.15%, the highest in New England, on top of a tax climate that already ranks among the worst in the country. A physician weighing rural New Hampshire, with no state income tax, against rural Maine can easily do that math. We are also the oldest state in the nation. Senior citizens are not having babies. High housing and energy costs push young families out before the nursery census ever recovers.
Closures are not a mystery virus that appeared in Damariscotta last month. They are the lagging indicator of an ever-tightening vice built over years by a majority that would rather manage decline than fix the economics of care.
When someone hands you a single villain and a street protest as the cure, tell them this story. Then hand them the receipts.
I am committed to Maine for the long haul. If you are too, start by putting real oversight pressure on the program that now covers roughly one in four Mainers. Sign up with Lead Maine to write a letter to the editor for the MaineCare Accountability Project at leadmaine.com/lte-signup.
Coverage without sustainable care is a slogan. Rural moms deserve better than another map with one fewer pin.
Laurel Libby represents Auburn in the Maine House and serves as executive director of Lead Maine.
