Community Forum | MaineHealth Lincoln Hospital

Birth data for FY2023-2025:

2025 birth data, by town:

The eight communities with the highest birth volumes (Waldoboro, Wiscasset, Jefferson, Whitefield, Nobleboro, Damariscotta, Boothbay and Newcastle) accounted for 167 births (76.6% of all service-area births), but only 54 births at MaineHealth Lincoln Hospital. This means MaineHealth Lincoln Hospital captured approximately 32.3% of births from those communities.

The National Institute of Health reports 200 births annually to be sustainable, if there are enough OB/GYN providers on staff. The average annual birth volume at MaineHealth Lincoln Hospital is around 130, with an average of only 18 deliveries per provider. 

Because the volume is low, we have been challenged to recruit providers and have not been able to recruit an OB/GYN since 2020. As a result, we currently rely on contracted providers, who work elsewhere, to provide coverage at MaineHealth Lincoln Hospital. 

This model has not proven to be sustainable, and we have been forced to go on diversion more frequently in the past year because coverage cannot be secured. Not having predictable coverage does not promote patient safety and is not patient-centered care. 

We continue to promote the maternity program through social media, birth announcements, press releases, community events and community class offerings—including childbirth classes for parents and new moms play groups, whether they choose to deliver at MaineHealth Lincoln Hospital or not. These efforts have not led to a significant increase in births over the years.

Alternative staffing models have been discussed with the steering committee, assessment work groups and the MaineHealth Lincoln Hospital board. To be clear, the cost of care, including staffing, is not the challenge – it is the inability to recruit providers given the high call ratio and low birth volume. 

MaineHealth Lincoln Hospital care team members, including providers, have been involved with the assessment of labor and delivery services. Our ongoing communication with providers and care team members continues to inform the conversation, and we have been transparent about the discussions that are taking place during the assessment process. 

The forums were designed for us to listen to and consider your perspectives during this assessment process. As a final recommendation has not been made from the assessment, no one should have been told that labor and delivery services are ending.

Labor and delivery is the only reproductive service being assessed. MaineHealth is committed to keeping prenatal and postnatal care at MaineHealth Lincoln Hospital and is seeking to improve access to other gynecological services.

According to a published study on choice of birthing location, results showed the following as the most influential: Safety vs. Risk; Influence of Family, Friends and Media; Presence or Absence of Choice; and Control and Access to Options. 

Being on call requires providers to be away from their family and to stay near the hospital while on call. While this model sounds like a good solution, we have learned from our recruitment efforts that this is not a tenable work solution for OB/GYN providers.

While MaineHealth can educate patients and providers about available services, physicians exercise independent medical judgment when recommending where a patient receives care. Referral decisions are based on patient needs, provider recommendations, and patient choice, not health system mandates. 

Family medicine physicians who complete an additional year of specialized training in obstetric care, including performing C-section deliveries, have been part of MaineHealth Lincoln Hospitall's maternity care model.

As part of the assessment, MaineHealth considered whether expanding the number of these specially trained physicians could help sustain labor and delivery services. However, this model has limitations. While fellowship-trained family medicine physicians can provide routine maternity care and perform C-sections, they are not trained to perform certain complex emergency procedures that may be needed during childbirth, such as emergency hysterectomies for severe bleeding or some urgent gynecologic surgeries.

In addition, maintaining a safe and sustainable on-call schedule would require at least four fellowship-trained family medicine physicians. Recruiting and retaining that number of specially trained physicians in a rural setting has proven challenging.

Yes. MaineHealth Lincoln Hospital has physicians who are trained to perform emergency deliveries. They participate in regular simulation training to maintain their skills in responding to obstetric emergencies.

Care team members have been actively engaged throughout the assessment process through committee meetings, town hall meetings, leader discussions, email updates, and frequently asked questions. In addition, physicians, advanced practice providers, nurses and other team members have had opportunities to share feedback, ask questions, and offer perspectives on potential options and challenges facing the Family Birth Center at MaineHealth Lincoln Hospital.

No care team members from labor and delivery are receiving severance pay. 

MaineHealth Lincoln Hospital is conducting a review of its obstetrics program due to ongoing OB/GYN recruiting challenges and the impact of low birth volume. 

No. We are looking at ways to redesign labor and delivery services to better meet the needs of our communities within the realities of our recruitment challenges and low birth rates at the hospital. 

Several factors contribute: 

• The median age in Lincoln County is 51, the oldest in Maine and among the oldest in the country, according to the US Census Bureau.  
• Nearly 7 of 10 expectant parents in Lincoln County are choosing to deliver at hospitals other than MaineHealth Lincoln Hospital. 

There are many factors: 

• Candidates do not want to be on call for multiple evenings a week to cover after-hours care. 
• OB/GYN providers want to be busier, and younger providers seek more opportunities to strengthen their skills which requires a higher volume of deliveries than we are seeing at MaineHealth Lincoln Hospital. 

MaineHealth Lincoln Hospital has not been able to recruit a full-time OB/GYN provider since 2020. The continued use of contracted, per diem providers does not allow for care consistency and stability.

In an effort to maintain access to high quality services across our region, MaineHealth is strengthening its regional structure and assessing the benefit of service delivery redesign.

MaineHealth has no plans to close services at MaineHealth Lincoln Hospital at this time. MaineHealth has invested more than $20 million to improve and expand access to important services such as infusion therapy and integrated primary care at MaineHealth Lincoln Hospital.

Of the 11 labor and delivery closures at Maine hospitals in the last decade, only two reduced services, neither of which were MaineHealth hospitals.

Today, 67 percent of Lincoln County’s expectant moms delivered their babies somewhere other than MaineHealth Lincoln Hospital – including MaineHealth Pen Bay Hospital, MaineHealth Mid Coast Hospital, Maine General and MaineHealth Maine Medical Center. 

While travel time is important, this data shows that for many it is not a deciding factor guiding decision-making. 

The average drive time for residents of Lincoln County would increase by 18 minutes or less. While a closure scenario would increase travel times, impacts vary by town and are modest for most patients.

In a closure scenario, only a small subset of patients would experience a drive time of over 50 minutes:

• 86% would have a drive time of 39 minutes or less
• 12% would have a drive time of 40-49 minutes
• 2% would have a drive time of 50 minutes or longer

We expect to complete our assessment by the end of June. Any recommendations would then be shared with the local community board for advisement before going to the Coastal Region board. Only the MaineHealth Board has the authority to approve any change, and they meet in August. 

We have been working closely with the maternity team to keep them informed and to incentivize them to stay while we complete this process. If changes to the service are made, we have plans in place to support team members in finding new opportunities. We have many openings available, and we are confident that we can retain anyone who may be impacted if change occurs.