A newborn sleeps at a hospital in Michigan on Feb. 26, 2026. Birthing care can be costly, requiring hours and hours of staff attention and intervention. AP File Photo/Corey Williams Northwestern Medical Center in St. Albans has partnered with an outside obstetrical and gynecological care group to continue perinatal and birthing care at the Franklin County hospital, bolstering a service the hospital has been struggling to permanently staff. After two or three physicians left the hospital in 2025, Northwestern’s interim CEO formally announced the hospital’s intent to keep its birthing center open in January, even though it would need to rely on temporary doctors to cover gaps in a 24/7 schedule.  “That is not how you want to run a practice, from a clinical, patient or financial standpoint,” NMC’s interim CEO Jonathan Billings told VTDigger in February. Still, the hospital struggled to recruit full-time obstetricians and gynecologists to take over its operation. It’s an unattractive sell, Billings explained, to ask someone to be the sole provider in a 24-hour practice with unpredictable hours. READ MORE Dr. Jennie Lowell, an OB-GYN and partner at Maitri Health Care, a private practice in South Burlington, has been working as one of these on-call doctors at NMC, in addition to her work at Maitri.  “I just got this idea in my head, ‘I think we can help save this birthing center,’” she said of her large Maitri team.  She and a committee at the hospital had been meeting since July to integrate the private practice. On Monday, they publicly announced the partnership.  Both Lowell and Billings described the partnership in two phases: The first is a contract agreement for Maitri’s health care providers to staff NMC’s obstetrical and gynecological clinics and do delivery during weekday working hours while serving on-call for births as much as possible. In this stage, NMC will continue to rely on temporary on-call doctors to fill in schedule gaps. Meanwhile, Lowell is recruiting two new full-time physicians to work for Maitri as the primary call responders in St. Albans.  Phase two, which she aims to have completed in two years, would see those providers fully integrated in NMC. Maitri would take over all birthing responsibilities, and the hospital would no longer rely on temporary doctors for off-hours birthing. Yet, she still worries about weathering the financial challenges that Northwestern has seen.  “It’s a concern. I’m not going to lie,” Lowell said.  NMC sees a higher share of Medicaid patients than Maitri’s private practice does in Chittenden County. It means that Lowell expects Maitri to make less money per birth at NMC. “I’m worried about that. If Medicaid doesn’t come up on their obstetrical (fees), I don’t exactly know how this is going to work. And that’s a little scary,” she said. Birthing is widely considered a loss-leader for hospitals. The expense of a birth, which can range from relatively quick, low-intervention care to hours and hours of staff attention and intervention, often outstrips what a hospital makes on a birth.  The annual cost to staff and supply its birthing unit was $3.25 million, said Kate Laddison, NMC’s spokesperson. Relying on the on-call doctors has been an “unsustainable level of multiple millions of dollars of loss” for the hospital, said Billings. The move to more permanent doctors aims to reduce that, though Billings said it will still be the service that loses the most money for the hospital.   “But it’s a much more sustainable level, and a level where the hospital board feels we need to carry that loss in order to preserve a crucial service in the community,” Billings said.  All across the country, rural communities have seen an increasing number of hospitals stop providing perinatal and birthing care. Copley Hospital, in Morrisville, closed its birthing operations and pre- and postnatal care last year.  The hospital’s birthing operations have not been financially sustainable “for a long time,” Billings said. He said that the hospital has been able to cover the cost through other sources of income, “but we cannot do that forever.” NMC has also seen a decline in births. In 2005, more than 500 babies were born at the hospital. Last year, that number was 311, the lowest in a steadily declining trend.  Billings hopes that bringing a more robust team to birthing in St. Albans will actually help increase those numbers again. Having a higher volume of births can also help that service earn more money, he said. Regardless of the financial realities, he and the Maitri providers are clear-eyed about preserving patients’ ability to access birthing and gynecological care in Franklin County. “Rural birthing centers all over the place are going out of business, and we’re trying to save this. That feels monumental to me, and really, really, just super exciting,” Lowell said. Read the story on VTDigger here: Northwestern Medical Center launches partnership to preserve birthing services. ...read more read less