Brattleboro maternity shutdown could mean more ambulance births, hospital leaders say

The planned closure stems from financial pressure, including rising operating costs, declining birth numbers and ongoing trouble hiring obstetric providers.

If Brattleboro Memorial Hospital ends its labor and delivery service, more babies may be delivered before families reach another hospital, the facility’s co-chief executive officers said Tuesday.

Dr. Elizabeth Montgomery and Dr. Tony Blofson said the change would likely send some expectant parents to nearby hospitals, while others could end up delivering in ambulances, private vehicles or emergency rooms along the way. They said the hospital is still weighing options even as it prepares for a possible shutdown of the maternity unit in six to nine months.

The planned closure stems from financial pressure, including rising operating costs, declining birth numbers and ongoing trouble hiring obstetric providers. The labor and delivery department is expected to lose $4.8 million this year.

Brattleboro’s situation is not without precedent. In Laconia, where Lakes Region General Hospital closed its maternity ward in 2018 for similar reasons, ambulance transfers of pregnant patients rose to Concord Hospital, roughly 30 miles away, according to Scott Lewandowski, deputy chief of the Laconia Fire Department. He said the city saw no such transfers in 2017, but six were recorded last year. Laconia Fire Chief Tim Joubert has said the city averages about two ambulance births each year on the trip to Concord.

Reports from that area also documented multiple babies born in ambulances, including four during a 12-month span ending in early 2021. Officials said at the time that two of those births probably would have happened in an ambulance even if the maternity unit had remained open.

For Brattleboro, Montgomery said the hospital could keep prenatal care in place while requiring deliveries to happen at another facility where the doctor has privileges. She noted that the physician would also need to be licensed in the state where the birth takes place.

The nearest hospitals to Brattleboro are Cheshire Medical Center in Keene and Baystate Franklin Medical Center in Greenfield, Mass., each about 20 miles away. Farther options include Southwestern Vermont Medical Center in Bennington and Monadnock Community Hospital in Peterborough, both about 40 miles from Brattleboro.

Blofson said the proposal has stirred deep opposition because the maternity service has been part of the community for generations. Montgomery said some residents strongly prefer that children be born in Vermont, reflecting a sense of identity that goes beyond medical logistics.

Birth volume at Brattleboro Memorial Hospital has also fallen over time. About 230 babies were delivered there in 2024, compared with 325 a decade earlier, Blofson said.

The small size of the department adds to recruitment problems, Montgomery said, because a limited staff forces obstetricians to take call more often. At the same time, reimbursements do not come close to covering expenses, she said.

Even if labor and delivery closes, the hospital would still be facing a substantial deficit overall. Brattleboro Memorial Hospital previously said the organization was on track to lose $14.5 million this year, though Blofson said that estimate may improve.

Despite the financial strain, both executives said they expect to meet with state health officials and the governor in hopes of finding a way to keep the service open. They also said the hospital is planning for two possibilities at once: a shutdown and a continuation of operations.