IRONWOOD –In September, Aspirus Health made the decision to change the obstetrics (OB) model in Ironwood at the end of the year. The announcement brought heated responses from several legislators in Lansing and the Michigan Nurses Association, but Aspirus cites a number of reasons for the decision to end non-emergency OB deliveries at its Ironwood hospital by Dec. 31.

According to its Sept. release, the region around Ironwood Hospital has a steadily declining and aging population, a small number of households with children, and low birth rates. The facility has averaged fewer than 90 births per year for the past five years, making it difficult to sustain high-quality delivery services due to the recruitment and retention of specialized team members and OB physicians.

Since June 2024, the hospital has operated with just one full-time family practice/obstetrics physician.

Natalie Seaber, Aspirus Michigan Region president, said Aspirus Ironwood would need a minimum of three full-time OB practitioners and staff to operate 24/7, for a hospital that experiences fewer than 90 births a year.

The Ironwood hospital is not alone in the state or the nation in this situation, says Seaber.

“When we look at rural critical access hospitals who have dissolved OB services in Michigan,” she said, “I think we’re down to only six in existence in Michigan right now. So it’s us, and it hit us late, because that’s been going on for several years throughout the U.S. and other rural communities.”

According to a July, 2025 a study led by the University of Minnesota School of Public Health, between 2010 and 2022, seven states saw at least 25% of all hospitals close their obstetric units. By 2022, eight states had more than two-thirds of rural hospitals without obstetric services.

Seaber said in the face of national trends, Aspirus can either dissolve anything OB and women’s services, which many facilities have done, or adopt a different model, which Aspirus opted for.

There are different models of service, Seaber said. With one model, a facility may have what she called a standalone birthing center, that tends to everything around the delivery, but the patient goes elsewhere for pre-delivery appointments.

Under another model, in which some hospitals have delivery, but the baby is not delivered by the obstetrician that has been caring for the patient for nine months.

“You get delivered by somebody called an OB hospitalist,” Seaber said. “Those are really big, high volume OB programs.”

A third model, an OB model, focuses on taking care of the mom during the first nine months, as well as after delivery, but not the delivery itself. This the model Aspirus Ironwood had to adopt, said Seaber.

“We’re going to still put the resources for prenatal (care) locally, and postpartum care will done locally,” she said.

However, deliveries will be elsewhere, with the nearest OB facility to Ironwood being the Tamarack Health Ashland Medical Center, which is 41 miles away, about an hour drive.

Seaber said nationally, it is not considered an absence of OB delivery care unless the nearest birthing facility is two hours or more away. At the same time, she said, all emergency departments in the United States are trained for emergency deliveries. Aspirus is not differing in this policy.

The Sept. release from Aspirus says Emergency department staff are receiving advanced training to manage unexpected deliveries, ensuring patient safety during the transition.