LINCOLN, Maine — Starting next spring, the sound of a newborn baby's first cry will be heard a lot less frequently at Penobscot Valley Hospital.
The hospital, in rural, Lincoln is ending nonemergency delivery services on May 1 due to a decline in newborns in the area and the departure of four physicians. The limiting of services is happening at hospitals across the state and the nation, and some health advocates say that's not necessarily a bad thing.
Five years ago, 100 babies were born at Penobscot Valley Hospital, situated between Bangor and Millinocket. So far this year, that number has dropped to 59. That's a steep decline, says hospital spokeswoman Kristie Libby.
"Most facilities our size — we're a small critical access hospital — they use a cut off of about 200 deliveries a year," she says. "Anything less than that, they start to look at the service and analyze whether you can provide great quality with such low numbers of deliveries."
Libby says what finally pushed the decision to end delivery service at the hospital was the impending departure of all four obstetrical service specialists within the next year or so.
"Normally [it] can take anywhere from 12 to 18 months to do a successful recruitment," she says.
Mothers in labor will now likely travel about 50 miles to Eastern Maine Medical Center in Bangor. Jeff Austin of the Maine Hospital Association says hospitals across Maine and the U.S. are grappling with similar decisions about what services to provide.
"The demographic shifts don't happen overnight," he says. "They take place over years and years. And at what point do you step back and say, this community has really changed over the past 25 years. Does our service delivery model reflect that anymore?"
Austin says while demographics and staff turnover are major drivers in eliminating certain hospital services, so too are flat or declining reimbursement rates for Medicare and Medicaid.
"Can you continue to meet the demand that's there at the reimbursement rates that are being offered?" he says."And so it's not just Maine, it's not just Pen Valley, it's all across the country."
Lisa Letourneau of Maine Quality Counts says Maine has an unusually high number of hospitals for its population — 38 for 1.3 million people — so it's actually good for hospitals to focus on the services that a community really needs, and to eliminate others.
"They are inevitable, necessary, and an absolutely critical element to restructure our health care system to be more efficient and high quality," she says.
Letourneau says while expectant mothers may have to travel, they will go to hospitals that likely have more resources and staff for deliveries. And Penobscot Valley Hospital, she says, will still do prenatal lab testing and ultrasounds, and their partners at Health Valley Network will provide prenatal and postnatal care.
"Which is really the vast majority of care that surrounds babies and moms and families in that community," she says.
Penobscot Valley Hospital is holding a community forum to discuss the changes at 6 p.m. Wednesday.