ERIN MCAULIFFE, 33, has worked at Merrimack Health’s Methuen campus – formerly Holy Family Hospital – for the last 10 years as a nurse in the maternity unit’s special care nursery. Both she and her mother were born at the hospital. In just a few weeks, McAuliffe will deliver her first baby there as well.
“This birthing center has been a big part of our lives. It’s something that is important to our whole families,” she said.
But on April 1, the three-campus health system announced that it plans to shutter the obstetric unit on August 1 and consolidate its maternity and neonatal services at Lawrence General Hospital, which is less than two miles away. The closure will eliminate Methuen’s 24 maternity and 10 special care nursery bassinet beds.
“Historically, these two hospitals competed for maternity services,” Merrimack Health CEO Diana Richardson said in a statement. “We are bringing together two trusted programs that will allow for a more seamless experience for mothers, babies, and families and greater collaboration among providers. By combining these services into a single center of care, Merrimack Health ensures continued access to maternity care locally.”
It will be the 12th in a string of maternity service closures – five of which have occurred in Gateway Cities – since 2010 in Massachusetts. In December, Mercy Medical Center in Springfield suspended its maternity unit, and the hospital has yet to announce a timeline for reopening. The state technically doesn’t have any maternity care deserts – counties without hospitals or birth centers offering obstetric care, and no obstetric providers – according to the nonprofit advocacy and maternal health research group March of Dimes. But experts and advocates have said that recent losses and impending cuts to Medicaid will make it harder to access maternal health care.
“The rate of closure is very similar for us as it is in other states,” said Chloe Schwartz, Massachusetts director of maternal and infant health initiatives for March of Dimes. “The only difference being, we started with more to begin with, so we don’t have any official deserts yet.”
The loss of labor and delivery units is a trend seen nationwide. Obstetric services are often not financially advantageous for hospitals due to low reimbursement rates from Medicaid, which pays for about a third of all births in Massachusetts. Nearly 73 percent of Methuen Hospital’s patient revenue came from Medicaid and Medicare as of 2023.
OB-GYNs have one of the highest malpractice insurance premiums across all medical specialties due to a high risk of lawsuits. And, maintaining operations amid a workforce shortage is costly due to round-the-clock staffing requirements in maternity units, including OB-GYNs, nurse midwives, anesthesiologists, and other supporting staff.
Declining birth rates also play a role in declining access to obstetric care.
The Methuen maternity unit averages fewer than two deliveries per day, according to Merrimack Health, and the special care nursery averages a daily census of fewer than one infant. Around two-thirds of the health system’s deliveries currently occur at Lawrence Hospital.
“Some days we don’t have many births. Other days, we have three or four births, and it’s really busy. It’s different every day,” McAuliffe said. “Our triage room is full every single day with patients coming in to be checked. We have multiple scheduled deliveries per week.”
About 85 employees will be affected by the consolidation. Merrimack Health said it anticipates that most of the impacted staff will have the opportunity to move into positions at Lawrence Hospital or elsewhere within the health system.
“A lot of people are feeling nervous. We have bills to pay, we have families to provide for, and we want to make sure that we have jobs at the end of the day,” McAuliffe said.
Merrimack Health said that Lawrence Hospital’s level three trauma center cannot be replicated at Methuen Hospital, and consolidating patients will ensure “that mothers do not need to be transported between hospitals during high-acuity, high-stress situations.”
Lawrence Hospital currently houses a 33-bed maternity unit with 10 special care nursery beds. More than 1,500 babies are delivered there every year, while nearly 800 are delivered at the Methuen campus.
“Many of our patients have had multiple babies with us, and they continue to come to us for care throughout the years. I’m sure for them, it’s a little scary that they would have to transition somewhere new,” McAuliffe said. “We do hope that we can combine and make a better environment for the whole area, but there’s still a lot of unknown in how that’s going to work.”
Alan Sager, a Boston University School of Public Health professor, said hospitals are not “interchangeable parts,” and shuttering a service “rips apart the fabric of care” where patients once felt comfortable.
Merrimack Health has notified the Massachusetts Department of Public Health of its intention to consolidate the unit, beginning a formal, 120-day process that will include a public hearing. Even if DPH determines that the unit is an essential service, the state has little authority over hospitals and service closures.
“Low patient volume makes it challenging for clinicians to maintain competencies, retain staff, and sustain the delivery of high-quality care,” Dr. George Kondylis, chief physician executive at Merrimack Health, said in a statement.
McAuliffe said many of the maternity unit’s nurses have been there for decades and stay until they retire.
“We feel comfortable having our own babies there and bringing our friends and family there,” McAuliffe said. “I’ve had the pleasure of being involved in many of my coworkers’ and friends’ deliveries in that unit, and a lot of us that don’t have kids yet are sad that they’ll never get the experience.”
