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Hospitals have been closing labor and delivery units, especially in rural areas. One birthing center in Minnesota found a way to stay open. Minnesota Public Radio's Molly Castle Work has more.
MOLLY CASTLE WORK, BYLINE: Nikki Johnson was 33 weeks pregnant and shocked when she heard that the rural labor and delivery clinic in town was closing. Instead of giving birth near her home in Fairmont, Minnesota, she was faced with the prospect of driving to another clinic affiliated with her hospital about an hour away when she went into labor.
NIKKI JOHNSON: I was like, that would be terrifying. Giving birth is, like, scary to begin with.
WORK: The Rural Health Research Center run by the University of Minnesota found that in 2024, almost 300 U.S. counties had lost hospital-based obstetric services in the past 14 years. Katy Kozhimannil is a public health professor with the University of Minnesota.
KATY KOZHIMANNIL: For every hospital that closes its obstetric unit or closes entirely, the nearest place to give birth gets further and further away. And that distance is associated with poor outcomes for moms and for babies.
WORK: Nikki Johnson gave birth at United Hospital District in Blue Earth, Minnesota, in the far southern part of the state. It's a rural hospital bucking the trend. It's not only kept its birthing center open, it's delivering more babies than ever. Richard Ash is CEO of the small nonprofit. He says they're the last remaining hospital in the county.
RICHARD ASH: If we're not doing OB, there's a big desert here. And there's a lot of people that are going to either have to move or take the risk.
WORK: Ash says the hospital is committed to protect obstetric services, and it's showing. He recalls that for years, the hospital delivered about 50 babies a year. By 2025, that number had almost quadrupled.
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WORK: Twenty-eight-year-old Maija Whitefeather-Manning gave birth to her first son at the hospital a year ago, and this day swaddles her newborn son. She and her husband are teachers at schools in town. She says she chose United Hospital District over larger hospital systems in bigger cities nearby because she feels heard and understood here.
MAIJA WHITEFEATHER-MANNING: In rural communities, we need local hospitals. And we need them to be funded and staffed. And despite the fact that maybe people see it as a financial risk or burden, it is truly, like, one of the most important things that we can put our money towards.
WORK: The chief medical officer at the hospital is Aaron Johnson. He says one of the ways they're able to make ends meet is by cross-training the medical staff.
AARON JOHNSON: If you're a small farmer, you're not just the one who drives the combine. You can drive a tractor, you can drive a truck, you can run a grain leg. You can do multiple things.
WORK: He says it's the same with rural labor and delivery units. They require 24/7 staffing because babies can come at any time. But that's pricey. United Hospital District staff work in other departments when they're not needed in obstetrics, reducing costs. For Johnson, keeping the labor and delivery unit open is a personal commitment.
JOHNSON: These are our neighbors. These are our family members. These are the people that we go to church with, go to school with, go to football games with. We want to provide the best care for them.
WORK: The University of Minnesota's Katy Kozhimannil says United Hospital District's strategy is what other successful rural hospitals are doing. And she hopes it'll serve as a blueprint for others. For NPR News, I'm Molly Castle Work in Blue Earth, Minnesota.
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