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Essentia's decision to end labor and delivery services in Fosston sparks outrage

Holding hands
Duluth-based Essentia Health will end labor and delivery services at its Fosston hospital.
Jeffrey Thompson | MPR News 2011

Essentia Health is facing public outrage after announcing it will end labor and delivery services at the Fosston hospital it operates in north central Minnesota.

About 40 community members gathered at Fosston City Hall Tuesday night to tune into a virtual public hearing on the matter, according to Fosston Mayor Jim Offerdahl. Roughly 100 others joined online.

The Duluth-based health care system said “declining birth volumes, increasingly high-risk pregnancies and challenges recruiting providers” spurred the decision.

Offerdahl told MPR News the city is prepared to take back the hospital, arguing Essentia is breaching a contract signed back in 2009.

Right now, there are two obstetricians practicing at the Fosston hospital. A third left in 2019.

“We also have confronted [Essentia] with evidence that we know that they have not made a good faith effort to hire,” Offerdahl said.

He says the hospital recently hired a third doctor who received a signing bonus from a foundation that supports the local hospital. However Offerdahl alleges an Essentia executive told that doctor they’d not have a viable OB practice in Fosston. As a result Offerdahl said that provider never started. The mayor says he believes Essentia had been planning to shut down deliveries for at least two years.

Essentia says centralizing labor and delivery services at its Detroit Lakes Hospital — which is more than 60 miles away — is a safer care model for patients. However, there’s growing concern that shuttering local L&D would create a maternity desert.

At the meeting Dr. Stefanie Gefroh, associate chief medical officer for Essentia Health West Market and division chair of women’s and inpatient children’s services, testified the situation in Fosston wouldn’t meet that bar.

“Across the country, there is increased attention to preventable maternal deaths. And bringing it back to what we’re talking about today is safety and quality of care. And that’s really at the heart of what our goals are for our patients,” Gefroh said.

Also testifying was Kate Moore who told the online crowd the last three generations of her family all delivered babies in Fosston. She recently had a baby at the Essentia hospital in Detroit Lakes after being told by her local doctor she couldn’t deliver in Fosston due to a nursing shortage.

The 45-year-old had to deliver via Cesarean section due to health problems and had requested a tubal ligation during the procedure. Moore testified Tuesday night no one informed her until she was ready to give birth that Detroit Lakes would not perform the sterilization procedure because it’s a Catholic-based hospital.

“So there I’m laying on the table, wide open … and I have to have another surgery now in Fosston — just want to point that out — in Fosston, to now have that done,” Moore said with a bitter laugh.

Chris Rubesch is president of the Minnesota Nurses Association and a registered nurse in Duluth. He says he and his many colleagues are used to servicing people from rural areas who no longer have OB care access nearby. The father to an 18-month-old said access to health care for all stages of his family’s lives played into deciding where they live.

“I just think that it’s worth considering as a vital community service and a nonprofit that there is also a responsibility to make sure that all Minnesotans everywhere, regardless of where they live, have access to the quality care that we know healthcare workers provide,” Rubesch testified.

Adequate access to obstetric care is a challenge affecting rural communities nationwide. According to a report from the Center for Healthcare Quality & Payment Reform, more than half of rural hospitals across the country do not offer labor and delivery services. From 2000 to 2015, 15 Minnesota hospitals stopped delivering babies. Mayo Clinic is on the brink of closing its ward in New Prague.

Offerdahl says Essentia failed to notify the city of their plans to end L&D 120 days in advance, as is required by state statute. He told MPR News unless Essentia discusses the agreement before arbitration, Fosston will end the operation contract entirely and put the hospital back under the control of First Care Medical Services.

Essentia declined an interview request as the issue is under arbitration

However in a written statement said it is committed to providing high-quality obstetric care and will “continue to offer excellent access for women locally, with expert prenatal and postpartum services available in Fosston. We work closely with our patients to ensure a seamless delivery plan at Essentia Health St. Mary’s-Detroit Lakes.”

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