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NH has lost 11 maternity wards in 20 years. Frisbie Memorial is the latest.

A map of New Hampshire with red X’s to mark where hospitals have closed maternity wards since 2002. There’s a line of closures cutting across central New Hampshire from Claremont to the Lakes Region and another following the Connecticut River Valley into the North Country. Blue boxes mark hospitals that still have labor and delivery units.
David LaFlamme
This map tracks maternity ward closures in New Hampshire since 2002. It doesn't reflect the latest planned closure of Frisbie Memorial Hospital's labor and delivery unit, recently approved by the New Hampshire Attorney General's office.

This story was originally produced by the New Hampshire Bulletin, an independent local newsroom that allows NHPR and other outlets to republish its reporting.

Citing cost concerns, Frisbie Memorial Hospital in Rochester has struck an agreement with the Attorney General’s Office to close its labor and delivery services two years early. It is the 11th hospital in the state to cease those services since 2000, worrying public health leaders.

“It’s truly troubling to me,” said Sen. Suzanne Prentiss, a West Lebanon Democrat who helped pass a bill last year to increase Medicaid reimbursement rates for birthing centers located outside of hospitals. “This is a gap of access to care. For labor and delivery of your baby, if you choose a hospital, there is going to be a gap of access to maternal health.”

The agreement with the Attorney General’s Office leaves just 15 hospitals and six free-standing clinics, with midwives, delivering babies in the state despite rising birth rates. The Concord Birth Center also plans to close this year.

Ellen Miller, spokesperson for HCA Healthcare, said the hospital will continue to provide all pre- and post-natal care, as well as gynecological services including gynecological surgery. Only births, which numbered fewer than 100 last year, will be transitioned to Portsmouth Regional Hospital, she said.

As part of the agreement announced Tuesday, HCA Healthcare, which owns Frisbie Memorial Hospital, will provide the Greater Rochester Community Health Foundation $2.75 million for its “charitable purpose,” including providing people in Strafford County help accessing labor and delivery services. The organization awards grants to organizations that provide care to people in the county.

In an emailed statement, Betsey Andrews Parker, chairperson of the GRCHF board of directors, was nonspecific when asked which labor and delivery services that will include. She said the organization is developing a strategy for awarding those grants, which it will post on its website.

“GRCHF’s mission is to improve the health and well-being and reduce the burden of illness of people residing in Strafford County and surrounding communities,” her statement said. “As a grantmaking institution, GRCHF will provide resources to community-based nonprofits that provide health and social services including making grants to organizations that provide services to pregnant people and their families.”

According to the foundation’s website, it offers grants to nonprofits that serve Strafford County-area residents with access to care, which can include care for mental health, substance use disorder, food security, housing, senior services, transportation and logistics, culturally appropriate care, awareness of services, care coordination, and patient motivation.

The Attorney General’s Office’s statement includes comments from Tim Jones, Frisbie Memorial Hospital’s chief executive officer.

“The reduced number of babies delivered at the hospital and across the region, and the departure of OB-GYN caregivers, necessitates the shift of labor and delivery services to our sister Portsmouth Regional Hospital facility and other community caregivers,” Jones’ statement said.

The state did not identify the community partners or whether pre- and post-natal care will continue to be available at Frisbie Memorial Hospital.

“When you close an OB unit, it’s not just where you deliver your baby,” Prentiss said. “It’s where you are getting your prenatal care and care after your baby is born.”

Prentiss is concerned the decline of OB-GYNs will continue as a result of the state’s abortion law, which calls for jail time and a fine for providers who violate it. Legislation that would remove those penalties received a tie vote from the House Judiciary Committee Wednesday; it now goes to the full House.

When HCA Healthcare acquired Frisbie Memorial Hospital in 2020, the Attorney General’s Office Charitable Trusts Unit required it to maintain labor and delivery services for at least five years unless it could show doing so led to a financial loss.

The agreement does not state the amount of money HCA Healthcare has lost on labor and delivery care.

When the organization announced in July it would ask for the state’s permission to end labor and delivery services, Diane Murphy Quinlan, director of the Charitable Trusts Unit, told the Bulletin her office would be evaluating whether the hospital “made a good faith effort” to avoid those losses.

Other providers who’ve ceased labor and delivery services have cited financial losses as well. The owner of the Concord Birthing Center told the Bulletin in July she’d decided to close because of ahuge increase in the price of malpractice insurance and insufficient reimbursement rates from insurance carriers and state Medicaid.

In an effort to help hospitals and birthing centers maintain labor and delivery services, Gov. Chris Sununu signed legislation in June increasing Medicaid reimbursement rates to hospitals and birthing services by 25 percent.

State public health advocates have cautioned that continuing to close labor and delivery services is an economic loss to a community but also poses increased risk for people who need those services. Portsmouth Hospital is about 20 miles from Frisbie Memorial Hospital.

“We … heard in testimony this past session how communities need to have basic services for their entire population in order to attract new residents to their community,” Trish Tilley, director of the Division of Public Health Services at the state Department of Health and Human Services, told the Bulletin in July when HCA Healthcare announced it would seek permission to cease delivery care at Frisbie Memorial Hospital. “It’s hard to attract young families if you don’t have a hospital that provides comprehensive care, including labor and delivery.”

Jones’ said in his statement that HCA Healthcare has invested nearly $27 million in upgrading Frisbie Memorial Hospital to ensure the best care for Rochester-area residents. Miller said those investments have included a new roof and new HVAC system, built a behavioral health pod in the emergency department, a new breast imaging center, as well as replacement and additions of new equipment for various clinical services.

The hospital also recently opened an inpatient acute rehabilitation center, Miller said, and will be investing additional money in that.

Rochester Mayor Paul Callaghan called the hospital a good community partner in a statement Wednesday. “Frisbie Memorial Hospital continues to invest and meet the ever-changing needs of our community,” he said.

New Hampshire Bulletin is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. New Hampshire Bulletin maintains editorial independence. Contact Editor Dana Wormald for questions: Follow New Hampshire Bulletin on Facebook and Twitter.

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