It doesn’t take much Google time to realize the nation’s hospitals are closing their labor and delivery services.

Maine Health’s recent decision to close the local L&D unit at Miles in Damariscotta is not unique. The American Hospital Association says more than 700 hospitals have shuttered their L&D units since 2010. By 2024, 57.5% of rural hospitals had no obstetric care.

The reasons are the same. Twenty-four-hour maternity units are expensive; they face staff shortages; demographic changes led to low birth rates; and Medicaid reimbursement rates for obstetrical care. Tough problems all. Even the Mayo Clinic, one of the nation’s most innovative hospitals, is closing maternity services at some of its rural Minnesota clinics.

Here in Lincoln County, a brave group of citizens, Miles Delivers Action Coalition, led by young women, is battling back, reminding us all that giving birth is one of the most dangerous things a woman can do. They tell us that for every story of loving and healthy deliveries, there are heart-rending stories of woe. The closure of local hospital L&D units forces women, especially those in rural areas, to drive hours to seek proper care. And it is the infants, not their mothers or their doctors, who decide when it is time to enter the world. Thus, L&D services require round-the-clock workers.

So, what can we do? Are we going to cease the grand work of procreation?

Money is the easy part. Governments can up the ante and provide additional reimbursement to cover hospital maternity services. That is a win-win measure that even the reddest and bluest politicians can support. No one wants to be caught denying money to help young mothers, infants and the doctors, nurses and midwives who care for them.

What about staff shortages? They tell us that doctors don’t want to work at a hospital that has few births. They want to work at their craft, not just sit around waiting for the next patient to walk in the door. Miles’ officials say they had just 130 births last year. You do the math.

Instead of waiting for patients to walk in the door, could hospital workers in other departments be cross-trained in obstetrical care?

Would hospital workers go for this idea? Other professionals perform more than one task. Could we provide additional funding to incentivize their decisions? Our hospital workers are some of the brightest, most dedicated, and caring of them all. They are among the best of the best. It seems to be part of their DNA. If offered a retraining package, especially one involving a financial boost, would they go for it?

Demographics tell us birth rates are down. Thus, hospital L&D units see fewer customers.

Business school grads tell us when your customer base is shrinking, you can wring your hands in sorrow, or you can figure a way to entice new customers in the door. Could hospitals advertise their well-known, caring, loving maternity services?.

For instance, Miles’ Damariscotta volunteers run one of the best thrift shops in the state. Their hospital volunteer counterparts in Boothbay Harbor run a great thrift shop, too. The marketing gurus tell us that thrifting for clothes and household items is one of the hot destinations for folks seeking to stretch the family budget. Is there a better place to advertise Miles’ great delivery services? Could the thrift shop volunteers help young mothers find high-quality, gently used baby stuff?

And then, could two of America's most powerful special interest groups combine to pressure the corporate American health care system to acknowledge they agree on the importance women place on maternity care?

Just imagine the women of the Right to Life movement sitting down with their enemies, the Right to Choose. One side encourages women to deliver healthy babies, while the other promotes the right of a woman to choose what she does with her body.

If a woman chooses to have a child, are not both sides on board with her decision? Would it be a stretch to see them joining to oppose corporate interests standing in the way of a woman’s ability to become a mother?

Take the saying,  "The enemy of my enemy is my friend.” The idea is to work together to defeat a common opponent. No one expects members of the two powerful movements to, well, share hugs and tea. But if they worked together, they could really put the squeeze on the corporate healthcare establishment, encouraging them to provide the best maternity care for the customers.

And the best maternity care does not include locking the door to the obstetrical department.