MANISTEE — By the end of this month Munson Healthcare Manistee Hospital will become one of hundreds of rural hospitals across the country that have closed their doors to expectant mothers.

The hospital's birthing center will close May 30.

Children also will no longer be admitted for overnight care at the hospital, though they will continue to be seen in the emergency room and at the Munson-Manistee walk-in clinic, said James Barker, hospital CEO.

The closure of the hospital's obstetrics unit will mean that 15 people — nine of them nurses — will lose their jobs.

Barker said a decline in the numbers of women giving birth at the hospital has made keeping the unit open very expensive. In March, he said, just six babies were delivered. Even so, two nurses staff the unit 24/7 and an OB doctor is always on call.

"We have a lot of time when we don't have moms and babies up there," Barker said.

Nurses and members of the community are fighting the closure. About 50 people picketed the hospital last week and about 4,000 people have signed a petition to keep the OB unit open.

Casey Waltrip was born at Manistee Hospital, as were her two young daughters. Waltrip said she is angry, sad and confused about the closure and feels compelled to fight for the nurses who took such good care of her and for the mothers who are now pregnant.

"I'm hoping the decision will be reversed," Waltrip said. "It's essential to our community. It's not just women and children who are affected, it's entire families."

A town hall forum is being held at 11 a.m. today in the Manistee High School auditorium to address the impact of the closure. State Rep. Jack O'Malley is expected to attend.

Kari Zoscsak works in the Manistee emergency department. The closure, she said, will have a huge impact on pregnant women, especially those who are low-income and may not be able to afford the transportation to a hospital an hour away.

"If they need emergent care they are going to be coming to us in the ER," Zoscsak said.

She also worries about the larger picture.

"I'm concerned that if you start chipping away at some of the base processes that take place here, what's left?" Zoscsak said.

The Michigan Nurses Association represents 75 nurses at the 45-bed Manistee Hospital. The organization, along with members of the community, is asking that a task force be formed to look into ways to keep the OB unit open. They also want to see the financial data that went into the decision to close the unit.

Manistee County Commissioner Margaret Batzer will moderate the forum.

"I haven't spoken with a single person who is happy about (the OB unit closing)" Batzer said.

The community is distraught over what will happen to mothers and their children, as well as the broader impact on Manistee, she said.

"It's really unfortunate that the trend to close maternity units in rural areas has affected us locally," Batzer said.

Michigan today has 133 hospitals, down from the more than 220 it had in the 1980s, according to the Michigan Health & Hospital Association. Of those, just 81 have obstetric units, with most located in urban and metropolitan areas.

The trend mirrors what is going on across the country as rural hospitals have a hard time attracting physicians to staff OB units.

Munson Healthcare in Traverse City is embarking on a plan to build a new Family Birth and Children's Center that will add a dozen OB beds to the 21 the hospital now has, add a new 15-bed pediatric unit and add 12,000 square feet to the neonatal unit.

Barker said Manistee Hospital is expected to deliver about 150 babies this fiscal year, which ends June 30. The seven-bed OB unit normally delivers 190-200 babies per year, he said.

Next year that number is estimated to drop to 90, he said.

"Assuming they're not all born on the same day, that would leave 275 days when we're not delivering babies," he said.

Manistee does not have a dedicated pediatrics unit, but sees about 1,900 children a year in the emergency room and at the clinic, with 20-25 of them being admitted per year. They are given beds on an adult medical unit, Barker said.

"We think it's better for those patients if they are admitted at another hospital," he said. "Kids get sick very quickly and it could be complicated."

Barker said his first priority is to take care of those mothers who are now expecting.

Maternity patients still will receive pre- and post-natal office care through the Manistee clinic. Mothers will have the option of delivering at the Munson Cadillac Hospital, about an hour away.

Cadillac Hospital has delivered about twice as many babies in recent years as Manistee, Barker said.

Other alternatives are Spectrum Ludington Hospital, about 40 minutes away, or Munson Healthcare in Traverse City, a little over an hour away.

About 40 percent of obstetric patients in Manistee County already go to Traverse City to deliver, he said.

Two physician positions will be eliminated, with one physician moving to Cadillac Hospital and another to Ludington Hospital. Four medical assistants will lose their jobs at the clinic.

Waltrip said the closure feels like an assault on women and children.

"We're just not a priority," she said.

If you go:

WHAT: Town hall forum

WHEN: 11 a.m today, Saturday, May 11

WHERE: Manistee High School Auditorium

WHO: Hosted by the Munson-Manistee Hospital Michigan Nurses Association. The public is invited to attend.