Calais Regional Hospital (CRH) will be closing its obstetrics department (OB) by the end of this year, which will leave only one hospital in Washington County equipped to deliver babies. The board of directors made the difficult decision to close the obstetrics unit following a careful review of the service line and operations. The review revealed that the hospital could no longer sustain the operation of the unit because of the declining number of births at the hospital and the heavy financial losses experienced by the unit. The move, though, is being opposed by the nurses union.
     Since 2007 deliveries at the hospital have decreased by nearly 50% C from more than 100 births per year to just 60 births last year, or an average of approximately one delivery per week. The overall birth rate in Washington County has declined steadily over the last 20 years as well, according to the most recent Census Bureau data. Declining use of the obstetrics unit, combined with the ongoing shortage of nursing staff in Maine, has led to increased costs and significant financial losses that can no longer be sustained.
     CRH board Chair Ron McAlpine says, "A hospital's services must always be provided to meet a community's healthcare needs, and the demand for obstetrics just isn't sufficient to maintain the service. Shouldering the significant costs associated with the program places an enormous strain on our financial operations." He adds, "This is a difficult decision that the board has not taken lightly, but we must take action to ensure the hospital remains financially viable so it can continue to serve our community in the years to come."
     However, nurses state that the closure will create an unsafe situation for new mothers and babies and will add hardship to local families. "We are deeply disturbed that Calais Regional Hospital would treat this critical department as dispensable, which is a disservice to mothers, babies and families," says Maine State Nurses Association (MSNA) President Cokie Giles, who refers to the action as a "dangerous decision."
     CRH's service area includes Baileyville, Eastport, Dennysville, Pembroke and the rest of northeastern Washington County. Melanie Howard, an OB RN, says, "Our community depends on us. How in the world can we force expectant mothers to go far outside of our community for the essential services that we provide?"
CRH administration states in a release that it will notify patients and referring physicians of the change and work to ensure a smooth transition for patients. Current patients who have questions about their care are encouraged to contact their OB physician.
     The hospital has no plans to reduce staff as a result of this change. Staff members in the OB department will have the option to relocate to other hospital departments. Staff in the emergency department will be trained and prepared to address emergency deliveries, and the emergency department will be equipped to monitor babies born during emergency deliveries.
     CRH CEO Bod Boula says, "Like rural hospitals across our nation, our success depends on having both the financial resources and the patient volumes required to ensure delivery of high‑quality care and patient outcomes. We take this responsibility seriously and are doing all we can to focus our resources on the services most needed and utilized by our community while ensuring the sustainability of our hospital."
     The hospital is actively pursuing opportunities to offer both prenatal and gynecological services in the local community. Other women's health services will continue to be available locally through primary care providers, including screening and testing services such as mammography, bone density, ultrasound, laboratory testing and more. Efforts are also under way to recruit additional providers in specialty areas, including pulmonology, urology and oncology, based on the needs and health conditions seen in the community.
     Boula says, "We appreciate the trust our community places in us, and we thank the outstanding OB staff for their dedication to Washington County families."
     However, Emergency Department RN Beth Ingersoll, chief steward of the Calais‑area MSNA chapter, comments, "This hospital spends over $400,000 on an outside management company based in Tennessee that has a history of reducing services to communities in order to extract more money. Resources should be spent right here, in Washington County on patients that need these services." Since 1992, CRH has been managed by Quorum Health Services. Its $400,000 per year fee does not include the salaries of the management personnel it employs. "We need to save our OB, boot Quorum out of our community and stand up for our patients," says Ingersoll.
     The nurses union is encouraging the public to attend a candlelight vigil to save the CRH OB on Friday, June 2, at 8 p.m. at Triangle Park in downtown Calais.
     Ericka Marshall, vice president of clinical operations, says, "We know there are some strong emotional ties to the CRH OB department.  Several generations of families, including my own, have had their babies born here. While this is a difficult decision, we remain proud of the excellent patient care and service that our OB department physicians, nurses and staff have provided to many families over the years."