In a recent development, North Memorial Health has made the difficult decision to close its special care nursery at its Robbinsdale hospital. The closure, which took effect last month, has sparked discussions about the impact on newborns and access to specialized care in the community.

The decision to shut down the nursery came as a result of declining birth rates at North Memorial. In 2022, the hospital reported 413 births, a significant decrease from the 549 births in 2018. This decline in births is reflective of a statewide trend, but it is worth noting that parents have been increasingly choosing North Memorial's newer hospital in Maple Grove, which reported a staggering 4,591 births in the same year, making it the largest birthing center in the state.

Nurseries in Minnesota are categorized into different levels based on their medical capabilities, with level three units having the capacity to provide intensive care for premature babies or those with complications. North Memorial previously operated at a level three but downsized to a level two nursery due to underutilization and financial constraints. Despite requesting special federal funding from the legislature to overcome these deficits, North Memorial's request was declined.

Dr. Todd Stanhope, North Memorial's vice president for medical affairs and medical director for labor and delivery services, explained the tough choice the hospital had to make. They had to decide between continuing to provide specialty newborn care with limited volumes or focusing on providing level one care for low-risk births, which they would be able to do exceptionally well.

Following the closure, North Memorial's specialty unit now sits empty, adjacent to their standard nursery, which offers single rooms for mothers and newborns during their recovery period. However, the closure of the special care nursery highlights a broader trend in Minnesota's childbirth capacity, with smaller hospitals in Fosston and New Prague also ceasing to schedule baby deliveries due to declining volumes, staffing shortages, and insurance costs. Allina Health has redirected all childbirths from Mercy Hospital's Fridley campus to its Coon Rapids campus.

While some hospitals, such as Lakewood Hospital in Staples and Ridgeview Medical Center in Waconia, are reporting an increase in births and investing in their neonatal units, the overall trend in Minnesota shows a decline in hospital labor and delivery services. Access to specialized care, especially in urban areas, has been impacted, with concerns raised about the negative outcomes associated with transferring newborns needing intensive care to other hospitals.

The closure of the neonatal intensive care unit in Robbinsdale has garnered attention due to the proximity to low-income and diverse neighborhoods where complicated pregnancies are more likely. Experts have documented worse outcomes when newborns requiring intensive care are transferred to other hospitals, as seen in a Japanese study of 100,000 births where preterm newborns experienced cognitive deficits when immediately transferred.

However, Dr. Stanhope highlighted that North Memorial is fortunate to be located near Maple Grove and two pediatric hospitals with level four neonatal intensive care units. The hospital aims to reduce transfers by counseling patients with complicated pregnancies to seek care at other hospitals. Despite the closure, North Memorial remains well-equipped with neonatal doctors and nurses available on-site 24/7.

To address the transportation challenge, North Memorial's ambulance division launched special NICU teams last year. These teams are trained to provide specialized care to vulnerable newborns in ambulances or helicopters, ensuring their safety during transport.

The closure of the special care nursery was announced in March, alongside the elimination of 103 jobs and outpatient mental health services. A state public hearing, which will review the closure, is set to take place on Thursday. Minnesota law requires hospitals to provide a 120-day notice before closing units or cutting services, allowing the public to offer their input in advance.

While the closure of the special care nursery is a loss, North Memorial Health had to make a difficult decision based on declining births and financial challenges. Efforts are being made to ensure that newborns receive appropriate care and that access to specialized services is maintained in the community.