A birth center closure should be the last cut a hospital system makes when care is working. In Troy, New York, it was the first.
A recent NPR report puts a hard question in sharp focus. Which matters more to a hospital system, profit or patient results? The Burdett Birth Center in Troy belongs to Trinity Health, a system with 91 hospitals and more than $25 billion in revenue. Trinity announced plans to close it. Its reason was simple. The center was losing money. Care that works, it turns out, can still lose to a spreadsheet.
Burdett put midwives and doulas to work alongside OB-GYNs. Together, they supported mothers who wanted to avoid a cesarean unless medically necessary.
The results stood out. According to 2025 hospital data, about a quarter of Burdett’s newborns arrived by C-section. Statewide, the figure was about a third. Burdett also reported fewer preterm births and fewer low birth weight babies.
Patient safety advocates have pushed for years to reduce surgical deliveries because they can lead to complications. So why close the center that was doing it?
Birth Center Closure Plans Meet the View From the Boardroom
Trinity said families could drive to Albany, up to half an hour away. However, a community survey found that 1 in 4 Troy residents had no access to a car. Meanwhile, hospitals have closed hundreds of maternity units since 2010.
One doula who helped lead the fight made a pointed observation. Numbers viewed from an office in another state can miss what a center means to the people it serves.
Troy pushed back. Midwives, mothers, and elected officials from both parties joined the campaign. New York’s attorney general opened an investigation and held a hearing in Troy. Trinity even sued the state. Still, after nearly a year, Trinity reversed course and kept Burdett open.
Troy won. Many communities do not. What happens when no one rallies?
Washington has seen this play out. In November 2024, Virginia Mason Franciscan Health closed its only Seattle birth center. The system’s president said the unit was under-utilized. Meanwhile, 55 nurses lost their jobs, and their union pushed back. Virginia Mason has since opened a new birth center downtown. Even so, the birth center closure left a pressing question. When volume and revenue drive the decision, who weighs the cost to families?
A birth center closure changes the stakes for a mother in labor. Obstetric emergencies leave little room for delay, and injuries to mothers and babies are often at the center of a medical malpractice claim. In Washington, healthcare systems owe patients a duty to maintain reasonable procedures for safe care. As corporations buy healthcare facilities, that duty rests with the system itself, not only the providers working inside it.
Burdett stayed open because Troy refused to accept the first answer. Not every community has the organizers, the officials, and a year to spare.
