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FOSSTON, Minn. 鈥� Some area residents expressed their disappointment and frustration during a public hearing discussing Essentia Health-Fosston's decision to close its labor and delivery services unit and direct those services to St. Mary's-Detroit Lakes.

Of the more than 140 residents who attended the virtual meeting, many said they were upset by Essentia's decision. Essentia faculty in attendance said it was no longer feasible to continue those services in Fosston.

鈥淲e don鈥檛 believe labor and delivery care can be offered in Fosston in a way that鈥檚 safe and sustainable,鈥� said Mark Thompson, president of Essentia Health West Market.

The Tuesday, Jan. 30, hearing, held by the Minnesota Department of Health, featured Thompson; Maria King, MDH health regulation director; Stefanie Gefroh, associate chief medical officer for Essentia Health West Market and division chair of Women's and Inpatient Children鈥檚 Services; Tanner Goodrich, senior vice president of operations at Essentia Health West Market; and Callen Weispfennig, administrator of Essentia Health-Fosston.

Stacy Sjogren, a management analysis and development senior consultant for MDH, served as the moderator.

At the meeting, Thompson said he appreciates "the ability to have varying opinions.鈥�

The purpose of the hearing was to explain why the labor and delivery services were ceasing and to allow attendees to ask questions or share comments. Through a presentation, Essentia Health cited the low volume of births happening at the hospital as the reason behind the unit鈥檚 closure.

Data provided by Essentia during the hearing showed the Fosston population was declining, and it is projected to decline further in the number of women of childbearing age in the next five years. Data from 2017 to 2021 showed an average of 72 births annually.

In areas with lower birth rates, the risk of maternal morbidity and mortality is nearly double that of higher-volume areas, due to increased difficulty maintaining surgical and nursing competency, as well as regulatory and credentialing requirements.

With fewer physicians working at the clinic, those available are stretched over a larger region, Thompson said. Because of this, Essentia Health-Fosston has decided to close its labor and delivery services unit, and has instead started a shared maternity care model, where local family physicians at Fosston will provide the majority of obstetrics care (preconception care, prenatal care and postnatal care), and collaborate with OB-GYN specialists at the Detroit Lakes hospital, where labor and delivery will occur.

Multiple attendees expressed frustration that the next nearest Essentia facility offering those services would be Detroit Lakes, more than an hour away. Gefroh replied that there is evidence to show traveling less than two hours will not cause an increased risk of morbidity and mortality.

Thompson added that the focus was on the systems in place, not individual care providers or other employees. Goodrich also said he wanted to clarify that those working at Essentia Health-Fosston鈥檚 hospital are a capable, talented team.

When asked why Essentia is not hiring more people to work at the Fosston location, Thompson said there are recruitment difficulties. When a possible new employee sees the declining population and birth rates in Fosston, that can dissuade them from choosing that location, he said. Gefroh added that, across Essentia, there have been OB-GYN positions open for more than two years.

Fosston City Administrator Cassie Heide said she expected both what the Essentia team would say, as well as the comments from Fosston residents in attendance. City Hall was open to residents who wanted to watch the hearing, and Heide reported more than 40 people filled the room. Some of those people were mothers, who voiced their own concerns and stories.

One mother mentioned how Essentia Health St. Mary鈥檚-Detroit Lakes refused to give her a tubal ligation during her cesarean section because of its status as a Catholic-based hospital. The mother didn鈥檛 realize this different hospital wouldn鈥檛 be able to perform this procedure.

鈥淚 think it鈥檚 important to have those personal experiences told,鈥� Heide said.

The City of Fosston plans to enter arbitration with Essentia to see if it can terminate its contract with the organization to regain local control of the hospital to reinstate these services.