Hospital birthing centers across the U.S. — particularly in rural communities — have been closing, one after another, for decades. More than 200 hospitals closed their obstetrics units between 2004 and 2014, according to the U.S. Health Resources and Services Administration. Three issues — financial pressure, insurance issues and doctor shortages — catch most of the blame. Declining birth rates also may contribute.

Munson Healthcare Manistee Hospital is about to become part of the continuing trend. Its birthing unit is slated to close on May 30.

Fewer mothers have been giving birth at the Manistee hospital. Just six babies were born there in March. Two nurses staff the unit 24/7 and an OB doctor always is on call. The closure will cause 15 people, including nine of the hospital’s 75 nurses, to lose their jobs.

Financial realities can be painful. Maintaining an obstetrics unit — which requires space, specialized equipment and personnel — costs money.

Hospital CEO James Barker said the decline in the number of women giving birth in Manistee has made keeping the unit open very expensive.

A 2016 report by National Public Radio stated that Medicaid pays for nearly half of all births in the U.S. — and pays about half as much as private insurance for childbirth. Those factors certainly contribute to Munson’s decision to close the Manistee unit.

Manistee’s expectant mothers, beginning in June, will need to trek away from their hometown to give birth in a hospital setting. They’ll need to drive 40 minutes to Spectrum Ludington Hospital, outside the Munson system and 40 minutes away. Or drive to Munson Cadillac Hospital, about an hour from Manistee. Or drive a bit over an hour to Munson Healthcare in Traverse City, where about 40 percent of Manistee County obstetrics patients already go for delivery.

The Traverse City hospital is planning a new birthing center that will expand its OB unit from 21 to 33 beds.

We’re sad to see medical services disappear from small towns like Manistee. But we’re heartened that Munson is committed to providing OB care for the region. It appears that economics and other factors convinced Munson to centralize some OB services.

Delivering a baby in a medical facility close to home is the ideal. That won’t routinely happen in Manistee after the end of May.

We trust Munson will do its best to provide a safe and pleasant birthing experience for Manistee mothers in Traverse City or Cadillac.

Even more troubling than the closure of obstetrics wards across the nation is the decline in the number of operating hospitals.

Michigan was home to more than 220 hospitals in the 1980s, according to the Michigan Health & Hospital Association. Today, only 133 hospitals operate in the state.

Sixty-seven rural U.S. hospitals ceased to exist between 2013 and 2017, according to the Medicare Payment and Advisory Commission’s June 2018 report to Congress on Medicare and the Health Delivery System. Communities are losing not only the possibility of having their children in their hometowns, but of receiving any kind of hospital care near home.

The Munson Healthcare system oversees nine hospitals across northwest Lower Michigan, facilities that serve communities from St. Ignace to Grayling to Manistee.

The consolidation of OB services may help the Munson system remain on a stable course.

We live in era of consolidation. We see it in our own business and consumers see it in our banks and grocery chains.

Consolidation frequently means some customers, clients or patients lose services or convenience. And some, at a very early age.

We’re sure Munson’s decision to close the Manistee birthing center was not an easy one.