Katie Gowell went into labor at her home in Patten, Maine, on June 1, 2025, expecting her family physician to deliver her fifth child. When a prolapsed umbilical cord—a medical emergency that cuts off oxygen—suddenly developed, her doctor, Dr. Rose Fuchs, kept the cord in position during transport. But the nearest hospital, Houlton Regional, had stopped delivering babies one month earlier, forcing an emergency diversion 40 minutes away.
The closure was the 11th maternity unit to shut down in Maine in a decade, leaving half the state’s 34 hospitals without obstetric services. The case exposes a rural maternal health crisis that is forcing pregnant women to travel hours for routine care and creating life-or-death risks when emergencies arise.
The Emergency
Katie Gowell’s labor began peacefully at her home in Patten, Maine, on the morning of June 1, 2025. Her family physician, Dr. Rose Fuchs, was there to deliver her fifth child, a birth Gowell had chosen to have at home after successful deliveries at the hospital with her first three children.
Within hours, the moment became an emergency.
A prolapsed umbilical cord—the baby’s lifeline compressed where it shouldn’t be—suddenly cut off the baby’s oxygen. Fuchs immediately took action, positioning the cord by hand to restore blood flow. She called for an ambulance.
What happened next exposed a larger crisis in rural healthcare. There was no time for delay, but Gowell’s nearest hospital—Houlton Regional Hospital, 40 minutes away—had stopped delivering babies exactly one month earlier. Initial responses from hospital staff suggested Gowell be transferred to Bangor, more than an hour away. The ambulance was caught in stormy weather that threatened to ground the helicopter that might have helped.
Fuchs fought to get her patient into Houlton. “We were with the ambulance trying to figure out where to go,” Fuchs recalled. “I was arguing, debating, pleading with the hospital and EMS — no, we’re going to Houlton.”
The hospital agreed. Gowell gave birth to Brooklyn Rose June Gowell—named after the doctor who saved her life—just before 8 a.m.
The Closure
Houlton Regional’s decision to stop delivering babies on May 2, 2025, was the 11th such closure in Maine in the past decade. It left half of the state’s 34 hospitals without obstetric services. The closest maternity units to Patten—a town of roughly 900 people on the edge of Maine’s northern wilderness—were now in Presque Isle or Bangor, both about an hour and a half away by car.
The hospital announced the closure on April 3, 2025, citing declining births, staffing shortages, and financial pressure. Hospital Chief Operating Officer Gina Brown noted that deliveries had fallen from 115 in 2020 to 83 in 2024. An independent financial review, the hospital stated, confirmed that closure would improve financial health.
The hospital notified the Maine Department of Health and Human Services of the decision just one day before making the announcement public—and 30 days before the actual closure. State policy recommends 120 days’ notice for permanent service changes to allow the state to monitor maternal care across regions. The notification was voluntary at the time, though a commission has recommended making it mandatory.
Houlton Regional did not respond to repeated requests for an interview.
The Nurses’ Alarm
Obstetric nurses learned of the closure hours before it became public. Jayme Hovey, a former obstetric nurse at the hospital, described the announcement as “very abrupt.” The chief operating officer was “in and out in less than five minutes,” Hovey said. The nurses remained in the room for more than an hour afterward, many in tears.
“I wasn’t looking for them to overturn it,” said Angela Davis, another former obstetrics nurse who resigned following the announcement. “I wanted them to say, ‘We hear you. We are also concerned about the women and children.’”
The hospital board declined requests to discuss the closure. On April 16, the nurses held a discussion anyway, with seven nurses facing empty chairs. A 10-minute film posted to Facebook showed unanswered questions about emergency birth protocols. As the camera panned across vacant seats, the nurses repeated one word: “Death.”
The Cascade
The closure rippled outward. More than half of the 40 patients scheduled to give birth at Houlton between May and November were transferred to Northern Light A.R. Gould Hospital in Presque Isle; others went to hospitals in Bangor, Caribou, and Augusta.
The Presque Isle hospital’s delivery volume nearly doubled. Average deliveries rose from about 14 per month between February and May to 26 per month in June and July, according to Northern Light Health. Katherine Scott, who had been six months pregnant when the closure was announced, was among those transferred. Both she and her husband had been born and raised in Houlton, and the same physician had delivered both of them and was scheduled to deliver her second child.
“We lost that small-town connection with our providers,” Scott said. “It was extremely heartbreaking and detrimental for us.”
She chose to be induced to avoid the risks of a natural birth so far from the hospital.
The Broader Crisis
The closure creates mounting pressure across the region. Alta Kauffmann, an Amish midwife, said that while most Amish women do not give birth in hospitals, one to two per month typically require hospital assistance. With the nearest facility now an hour and a half away by car—a barrier for families who rely on horses and buggies for travel—informal arrangements that once worked may no longer be reliable.
“It’s just a very insecure feeling,” Kauffmann said, “because we have no backup plan.”
Dr. Fuchs has seen the impact in her Patten practice—a converted house with floral wallpaper and a bay window full of toys, staffed by herself and two assistants. Her waiting list exceeds seven pages, and she no longer accepts new patients, though people call daily seeking care.
She has assisted with two emergency births since the closure. One patient gave birth at her clinic because Houlton was no longer an option and Bangor was too far. Another involved a mother with a liver condition requiring specialized treatment who would have gone to an OB-GYN at Houlton under normal circumstances.
“Everything is well that ends well,” Fuchs said. “Those children are all born now and still living and fine. But talk about stress for those of us who take care of these patients.”
Gowell said the closure has shaken her confidence. “If I was to get pregnant again, I would be worried,” she said. “We need to take care of our people. We can’t just keep closing down rural Maine.”
Recently, Fuchs received a promotional flier from Houlton Regional announcing new services: cardiology, behavioral health, orthopedics, obesity management, and advanced imaging technology. The hospital wrote: “We’re proud to grow alongside the people we serve—bringing advanced, compassionate care to the place we all call home.”
Fuchs was grateful for the additions. But the flier left her with a question: “Why can’t we put OB on that list?”