File photo In 2022, Warren General Hospital renovated its maternity unit rooms.

Warren General Hospital administrators were fully aware they had been bucking a national trend. As the number of rural hospitals across the United States began closing maternity units over the last decade, this Warren County, Pa., facility was thinking primarily about care for its residents.

“It’s important for us to continue this,” said Rick Allen, former hospital chief executive officer in 2022 after the institution invested more than $2 million into its unit that had about 200 deliveries per year. “The board said, ‘We need to offer services our community needs.’ ”

Less than four years later, reality struck — through no fault of leadership at the location. According to a news release issued this week, the hospital’s Obstetrics and Gynecology program has been maintained by two physicians in recent years. On Dec. 29, the hospital was notified one of those physicians would not be participating in the delivery of babies for the foreseeable future.

This happened despite the organization’s best efforts to expand its OBGYN program, including contacting 28 OBGYN residency programs in Pennsylvania, Western New York and Eastern Ohio – in attempts to connect with potential OBGYN physician candidates.

Entering a competition for doctors, especially for smaller hospitals, can be a losing proposition.

Medical providers, who do get a start in rural America, often quickly move to larger markets. Those locations offer additional lifestyle perks — and more money.

“Many members of our administration were born at WGH,” said Dan Grolemund, current Warren General Hospital chief executive officer. “We understand the magnitude of this decision and the need to support pregnant women in our region. However, with our options being extremely limited, we feel this array of solutions is the best to provide our patients with high-quality, reliable women’s health care moving forward.”

Twenty-five years ago, couples in Chautauqua and Warren counties had four options if they were expecting. That number has dwindled to one as UPMC Chautauqua in Jamestown, which invested $20 million in upgrades in 2018 that included the maternity department, continues services for expecting mothers.

Westfield Memorial Hospital, which recently transitioned from a small inpatient hospital to a 24/7 emergency, observation, and outpatient care facility, ended deliveries in 2008. In October 2021, Brooks-TLC Hospital System in Dunkirk halted labor services suddenly. Warren reluctantly joins that list starting Tuesday.

Eliminating maternity operations are decisions by smaller hospitals that have an eye on the bottom line. Though Warren General deserves praise for attempting to keep the procedure going, there is no doubt that financial struggles have a role.

In its most recent public filing of Internal Revenue Service 990 forms, the location reported a deficit of $1.9 million. That’s not an indictment on how the facility was being run, it is just a reality of the changing health-care model. Even the UPMC network reported a $339 million in operating losses in 2024 though its finances had shown a marked rebound throughout 2025.

Overall, Warren General paid out $38.4 million in salaries and benefits for the period from July 1, 2023, to June 30, 2024. It also paid out $5.2 million for contracted nursing and other services as well as hospitalists and emergency room physicians.

All big costs for a small operation that serves a population of 39,000 county residents.

Looking at the national picture is even more disconcerting. A Center for Healthcare Quality & Payment Reform noted that since the end of 2020, “117 rural hospitals have stopped delivering babies or announced they will stop before the end of 2025 — an 11% reduction in rural labor and delivery units. Over the past five years, rural obstetric units have closed in the majority of states, and in three states, one-quarter or more of the rural maternity hospitals stopped delivering babies.”

Warren General did its best to not be part of those statistics. Their actions this week were something out of their control.

“Despite our exhaustive efforts and the support of our legislative leaders, the national shortage of OBGYN specialists has made it impossible to secure the staffing levels required to safely maintain a 24/7 labor and delivery unit at this time,” Grolemund said.

Making matters worse, the Center for Healthcare Quality & Payment Reform notes that more than 120 rural hospitals still delivering babies lost money in both of the two most recent years, and could be forced to close labor and delivery services in order to survive. In nine states, at least one-fourth of the rural maternity care hospitals are in this situation.

As these examples indicate, Warren is far from alone — as Dunkirk and Westfield can attest. There is no doubt other small facilities are heading down this road.

Babies are supposed to bring joy. Now, in many cases, their arrival happens far from home.

John D’Agostino is editor of The Post-Journal, OBSERVER and Times Observer in Warren, Pa. Send comments to jdagostino@observertoday.com or call 716-487-1111, ext. 253.