After a decade during which both of Missoula’s two hospitals delivered babies, only one will continue to do so after Friday, part of a nationwide trend of declining maternity care.
Providence St. Patrick Hospital will close its Family Maternity Center, effective Oct. 10, because of “external challenges” including a declining number of births at the hospital and workforce shortages, hospital officials said in announcing the decision.
Missoula’s other hospital, Community Medical Center, which delivered about 1,300 babies last year, has spent several months preparing to take on most of St. Patrick’s 400 to 450 annual births, said Hollie Nagel, Community’s chief nursing officer.
“All this was decided independent of us,” she said. “We’re going to continue to do what we need to do to care for our community. We’ve done maternity care for a long time, we’ve been known for it, and will add to it.”
St. Patrick Hospital, run by Catholic nonprofit health care organization Providence, reopened its $5 million maternity center in 2015 after a 40-year hiatus, the Missoulian reported at the time. Western Montana Clinic, an independent provider, housed its obstetrics and gynecology department at the hospital, and only clinic doctors delivered babies there. The clinic has since moved its OB-GYN department to Community Medical Center’s campus and will begin seeing patients there Oct. 13.
“Missoula and surrounding communities will continue to receive excellent obstetric and gynecologic care from the physicians at Western Montana Clinic,” said Krissy Petersen, chief nursing officer for Providence Montana, in an emailed statement. “Providence St. Patrick Hospital will miss our Family Maternity Center colleagues; we are grateful for their compassion and dedication. About one-third of the care team have new positions and will remain with Providence.”
When Providence announced the closure in June, Western Montana Clinic OB-GYNs released a letter criticizing what they described as lack of consultation with the clinic and providers.
In a letter to St. Patrick administrators, the Family Maternity Center staff members expressed “disappointment and concern” regarding the closure and the short notice.
Western Montana Clinic President Dirk Gottman told Montana Free Press the new collaboration with Community came together quickly and said the hospital has worked closely with the clinic during the transition.
The clinic sent letters and messages through its electronic health records system to all OB-GYN patients notifying them of the move, which was also discussed during appointments, Gottman said. At least 90 patients with due dates in October, November and December initially expected to give birth at St. Patrick Hospital and had to change plans, he said.
“Our OB-GYNs provide excellent care,” Gottman said. “We are doing our best and have made every effort to make sure that care is seamless and the transition is not noticed. We’re obviously in a different location, and we will have our offices and ability to see patients up and running and will continue to provide the same excellent care.”
Western Montana Clinic patient Mercedes Courchesne-Stedman found out she was pregnant just days after Providence announced its closure. The Missoula nursing student told MTFP the providers she initially asked about the change did not know where the clinic would be moving and said there seemed to be a lack of communication with patients. As of Oct. 1, Courchesne-Stedman wasn’t aware of the date the clinic was moving to Community’s campus.
“With already stressing about being pregnant, figuring out nursing school and not knowing where my doctor is going … I kinda feel like we’re just winging it,” she said. “I don’t feel like it’s healthy for an expecting mother.”
Courchesne-Stedman said she initially chose St. Patrick Hospital because her sister gave birth there, and a family member suggested it because she has a high-risk pregnancy. Finding a doctor who is accepting new high-risk patients was “a huge issue,” but she eventually found one, Courchesne-Stedman said.
Community’s Chief Nursing Officer Nagel said she wants hesitant patients to know that the hospital’s staff “do this work every day, we do this work well … and we want them to feel safe with us.”
“I’m kind of excited about the opportunity to change perceptions for someone who maybe doesn’t want to be here,” Nagel said. “Our mission is making the community healthier. This is one more way we get to do that.”
Community’s Women and Newborns Unit includes OB-GYNs as well as maternal-fetal medicine and family medicine doctors, Nagel said. The hospital has a neonatal intensive care unit that has long received transfers from St. Patrick and other hospitals in the region, she said.
While Community Medical Center saw a dip in its number of annual births following the opening of St. Pat’s maternity center in 2015, births have gone up about 5% to 7% annually over the last five years, Nagel said. To prepare for the St. Pat’s closure, Community created a transition team to determine equipment and staffing needs as well as contingency and surge plans, she said.
The hospital has in-network agreements with all major insurance providers and plans and is working with St. Patrick Hospital to ensure a smooth transition for patients and providers, said Megan Condra, Community’s director of marketing and community relations.
Community Medical Center also hired 20 new obstetrics staff and increased operating room staff for the anticipated increase in gynecological surgeries, Condra said.
Beth Maurer, a labor and delivery charge nurse at Community, told MTFP Oct. 2 that she was training a former St. Pat’s nurse and that other providers who used to work at Community have returned.
“We’re excited to have their experience,” she said.
Gottman, with Western Montana Clinic, said Community has been welcoming and accommodating to his clinic’s five doctors and two nurse practitioners. While there are lots of opinions regarding Missoula’s hospitals, Gottman said he is not concerned about returning to Community being the only local hospital with a birthing facility. Concentrating expertise in one location allows more people to be familiar with emergencies or things that could go wrong, he said.
However, an overall closure of obstetrics units nationwide is concerning because it limits women’s health care choices, Gottman said.
Between 2010 and 2022, 238 rural hospitals and 299 urban hospitals nationwide stopped offering obstetric care, according to a study of nearly 5,000 hospitals published in 2024. During that time, 26 rural hospitals and 112 urban hospitals added obstetrics services, the study found.
About 35% of U.S. counties don’t have a birthing facility or obstetric clinician, according to a 2024 March of Dimes report. Six in 10 of such “maternity care deserts” are in rural areas.
Since 2020, more than 100 rural hospitals have either stopped delivering babies or announced plans to end the service by 2025, according to a report by the Center for Healthcare Quality and Payment Reform. That includes Clark Fork Valley Hospital in Plains, located northwest of Missoula, about 25 miles east of Thompson Falls. The critical access hospital ended obstetric delivery services Jan. 1, 2024, because of declining births and difficulties in recruiting staff to provide around-the-clock coverage, according to the hospital’s announcement.
Logan Health-Cut Bank, located north of Great Falls near the Blackfeet Indian Reservation, also ceased delivery services in recent years, said Katy Mack, the Montana Hospital Association’s vice president of communications and member engagement.
Labor and delivery is an expensive and challenging service for hospitals to support in any Montana community, especially those where populations and birth volumes have decreased, Mack said. Workforce shortages, the high cost of constant care and the rising cost of supplies, equipment and medications put economic pressure on hospitals, she said.
“Even larger hospitals tend to subsidize these services in order to ensure the service remains in the community,” Mack said. “The overall financial health of our hospitals is critical to ensuring they can continue to operate services that run at a loss.”
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This story was originally published by Montana Free Press and distributed through a partnership with The Associated Press.
