When rumors about closing the Copley Hospital Birthing Center started to circulate last year, Sarah Chouinard, the president of the hospital’s nurses union, and many of her colleagues thought they were just that: rumors.
“There have always been cycles of this threat of closure,” she said. “But we’ve been protected because of community public relations and the service we provide for the community.”
Then, one of the hospital’s four midwives scaled back her hours to work on an as-needed basis. The hospital initially made no plan to hire a replacement, then posted the job, found a good candidate but never made the hire. The other three midwives grew suspicious.
Chouinard also began emailing Copley President Joe Woodin, similarly seeking clarity: Were these just more rumors swirling around the birthing center? Would her nurses need to worry about being reassigned?
She said she got no response.
“The more that was not said, the more we knew what was happening,” Chouinard said.
In March 2025, the Morristown hospital announced it was launching a comprehensive review of the birthing center to explore closing or expanding its operations. Those were the options suggested by a landmark report published by a state-hired consulting firm last year that outlined radical changes needed to make the health care system in Vermont more accessible and affordable.
Hospital leadership said it does not plan to make a decision until a consultant hired to do the review submits its recommendations, which are expected in mid-June. The hospital’s associated Women’s Center, which hosts gynecological and obstetric care, is slated to remain open, regardless of the hospital’s decision on the birthing center, according to hospital spokesperson Barbara Walls.
Still, the threat of losing such a beloved center has left the community incensed.
Supporters of the birthing center quickly created an online petition, which has garnered more than 2,500 signatures. Advocates hosted a Mother’s Day rally in support of the center, peppered their yards with lawn signs, and wrote countless letters to the hospital and public in hopes of underscoring just how great a loss the closure of the Copley Hospital Birthing Center would be for Lamoille County.
The public outcry reached such a boiling point that Copley decided to postpone its annual Stowe Art Wine & Food Fundraiser over concerns about a planned protest at the event.
The midwife model
Advocates argue the closure of the birthing center would not only leave the community without a local place for delivery, but it would also jeopardize what patients and providers consider to be a model for midwife-driven care.
When a pregnant patient comes to the center, a midwife leads their prenatal visits and development of the birthing plan. The clinic’s two OB-GYNs are part of that broader care team but only become hands-on with a patient’s care if there is a need — like gestational diabetes or hemorrhaging in birth, Kopas said.
“It’s a different approach that puts the pregnant person at the center of decision making,” said Mary Lou Kopas, one of Copley’s three full-time nurse midwives. “(The model) looks at pregnancy and birth and breastfeeding as normal physiologic processes and not medical emergencies waiting to happen.”
She said the approach also centers “shared decision making,” where the provider takes time to listen to the patient’s specific needs, lifestyle and circumstances in forming a birthing plan. “It’s not a one size fits all,” she said.
Patients believe that this approach is what’s made their experiences so positive.
“It’s such a special place. It’s the only time that I’ve had an interaction with the medical system where I left that interaction feeling like I was treated with dignity and respect,” said Eva Zaret, a public health specialist who had both her children — a 3-year-old and a 9-month-old — at Copley.
Zaret said she had a history of managing an eating disorder and had intense anxiety about gaining weight during pregnancy.
When Zaret began explaining her worries, the midwife walked her through the possible alternatives, and “then the midwife just put down everything,” Zaret said. “And she just looked at me, and said, ‘What do you need?’”
Zaret told her she didn’t want to be weighed at her appointments, to which the midwife simply said “OK.” That was it.
The birthing center also scores highly on one important marker of high-quality birthing care: Copley often cites that it has one of the lowest rates of C-section births in the state.
At Copley 1 in about every 10 births is a C-section delivery, Kopas said, while nationally, that rate is closer to 1 in every 3. Part of that low rate, however, may be due to the fact that Copley is only able to accept low-risk pregnancies.
Midwifery care has been associated with fewer preterm births, reduced labor interventions, and lower maternal and infant death and illness, as various control trials and observational studies have shown.
“I think that Copley should be held up as a model — beyond just ‘you should have (this) many midwives on for this many hours.’ People should go shadow and see ‘how do I talk to a patient? What does it really mean to be trauma informed? Or, what does it really mean to be patient centered?’” Zaret said.
Paying for pregnancy
When the consulting firm Oliver Wyman issued its report in September 2024, outlining ways to improve Vermont’s health care system, it recommended developing more regional “centers of excellence” for specialized care.
For Copley, the report suggested scaling up to become a regional center of excellence for orthopedics. The report did not identify Copley as one of the four hospitals where major restructuring would be needed to stay afloat.
The report, and thus Copley’s review, is part of a bigger push to scale back ballooning healthcare costs in the state.
“Our health system is experiencing an intense cost crisis, and also an access crisis,” said Brendan Krause, the director of health care reform at the state’s Agency of Human Services. “We’re seeing the cost crisis not just in hospitals, but also with our state regulated insurance market — which doesn’t just mean more, higher premiums for individuals and businesses. It also means it is more expensive to create jobs; property taxes go up.”
“I would say this (review) is very much aligned with what a state has asked them to do. And, I would trust the hospital and the board to review the data and listen to their community and make the decision, according to the best information they have,” Krause added.
Delivery nurses and midwives expressed frustration that there was little communication with their department about how to make the center more profitable. In late May, the board met with some of the midwives and providers to collect their input on how to close or expand, something providers had long been asking for. They and other stakeholder groups have been given an hour of time to share these ideas, observations and questions with the consultant.
Copley says the birthing center operates at a loss of $3 million to $5 million annually. Because commercial insurance rate increases are approved annually by the Green Mountain Care Board, a statewide health care regulator, Copley has been limited in what it can charge and how quickly it can increase those charges. As a result, currently, the hospital bills private insurers around $7,000 for a low-intervention, vaginal birth, while other large hospitals charge more than twice that number.
“Our costs are fixed. We do not have the ability to change those costs,” said Barbara Walls, the hospital’s spokesperson.
When the Green Mountain Care Board set commercial insurance price increase rates in September, Copley pushed for an 11.8% increase in costs, Walls said. The board trimmed that request significantly to 3.4%, a rate increase that all hospitals were required to stay at or below.
The board allowed Copley a total of 15% increase in commercial rates the previous fiscal year — 8% in September 2023 and an emergency additional 7% in April 2024.
Kopas and her colleagues see room for the program to draw in more money without raising costs: “I do think there is capacity to grow this program — could easily do 10% more births without increasing staffing,” Kopas added.
One way of doing that, she and others suggested, would be to put a satellite prenatal clinic in Waterbury, where the hospital has recently expanded its orthopedic services. It would allow them to catch a larger array of patients right off Route 89, Kopas said.
Still, Walls said that an expansion and upgrade to the birthing facilities may not directly correlate with an increase in patients and revenue. Walls said 42% of the births in Lamoille County occur at the hospital.
“That’s 58% (of births) that are not happening at Copley,” she said.
Part of that may be due to the fact that Copley can only accept low-risk pregnancies. Anyone who might need a Newborn Intensive Care Unit gets referred elsewhere, usually, to University of Vermont Medical Center in Burlington.
The hospital often cites low birth rates, which the Wyman report highlighted, as a reason to close the facility. The report identified a low volume of deliveries as a reason for the hospital either to “grow or shift birthing to other organizations.”
The report set a threshold of 240 births a year, as sufficient to offset the costs of running birthing operations. Copley has been well under that number since 2010, with birthing center deliveries landing between 160 to 200 a year. Since 2018, those levels have plateaued around 160 births a year.
North Country Hospital in Newport and Northeastern Vermont Regional Hospital in St. Johnsbury, both of which draw from regions that overlap with Copley’s service area, also had birth volumes beneath the Wyman report threshold.
Kopas interpreted the data differently, saying birth rates have remained steady and that this year’s due-dates are on track to keep the hospital in the same ballpark. Plus, Lamoille County is growing, she said.
Walls questioned whether that growth would make a difference.
“Yes, Lamoille County is growing, but is it growing with people who are planning on having additional children?” she said. “And would they be planning on having those children here?”
When Kim Horne and her husband were looking to buy a house in Morrisville in early 2020, their real estate agent highlighted the house’s proximity to Copley and its birthing center.
“Like a lot of our friends who have also recently moved to the area, we were looking to start a family,” she said. In January 2024, she had her first child at Copley and is planning on giving birth to her second child there next month.
Community care
Many stress the importance of the fact that Copley is a community hospital as one of its great selling points — both because of the proximity it gives patients and the staff’s connection to the county.
“It’s a community, and there’s even a family feel to it,” Chouinard said. “You realize you start taking care of generations of people – of babies’ babies.”
Chouinard grew up in North Wolcott, went to Stowe High School and then the University of Vermont. She started her career at Copley before becoming a travel nurse, and in 2011 she returned to Copley and has stayed there ever since.
“I was so excited to really take my skills and experience and do something here at home,” she said.
To patients, that community investment shows.
“I think you could take any OB unit at a hospital, and you could staff it up with a 24/7 midwifery model, and you wouldn’t get what Copley has,” Zaret said. “They have worked very intentionally for a long time to create a culture there that really values their patients.”
Moreover, many worry about what the absence of a local place to give birth will mean for patients.
“That’s going to be a mess,” Chouinard said. “Ambulances don’t want to deliver babies, ERs don’t want to deliver babies. There are a lot of ‘what-ifs’ (to risks associated with birth) but we’re supposed to be here for the ‘what ifs.’”
Others worry that closing the birthing center would decrease prenatal visits — though Walls stressed that its Women’s Center will remain unaffected. Patients will still be able to access their pre and post natal care at Copley.
Horne, who is eight months pregnant with her second child, worries about what any additional travel might mean for patients before they give birth. Her first baby was head down, but flipped, before she went into labor.
“It was excruciating,” she said. “I couldn’t put any pressure on my pelvis or my lower back whatsoever. I couldn’t walk, I couldn’t sit, and when a contraction would happen, and I was seated in the car, even just for the tiniest commute, I was like lifting myself up in my seat,” she said, adding that having to make a longer drive “would have been dire.”
But to her, a community hospital represents more than just drivetimes. It’s about the investment a hospital has in its patients’ care, beyond profits.
“I’m not trying to be harsh or anything, but (if you close your birthing center), you can’t really call yourself a community hospital anymore because that’s such a vital pillar of a community,” she said.
Walls said that the hospital knows that and is taking this to heart.
“We understand that this is very emotional. It’s a deeply human process of birthing and creating new families, and we understand and respect that,” she said. “That being said, the temperature has gone up higher and higher, the more we have been forthcoming and transparent and acting from a place of integrity, the more we have received suspicion.”
For now, the hospital and its community members are in a holding pattern until the consultant’s report returns with recommended paths of action.
Still, Kopas sees the low monetary value placed on midwifery care and birthing in general as part of a deeper systemic issue.
“Why is care that is essential to people with a womb an expendable portion of care?” she asked. “I mean, this is primary care for women and other childbearing people. This is essential care. So why is it expendable? That just angers me. I see it in a bigger picture of misogyny in our culture. Why is this care not reimbursed at the value?”
