At least 26 hospitals have ended maternity care so far in 2026, including four Chicago-area hospitals within the six weeks.
Over the past seven years, at least 10 hospitals have closed a maternity ward on Chicago’s South Side and in the south suburbs, NBC Chicago reported Oct. 31.
Saint Anthony Hospital on Chicago’s Southwest Side has not retreated. The independent community hospital has averaged more than 1,000 deliveries a year since 2023 — a figure its president and CEO credits to a midwifery-led model and the community relationships that sustain it.
Dorval Carter Jr. took the helm at Saint Anthony in early 2025, bringing with him more than a decade of board service at the hospital, most recently as board chair. His connection to the institution runs deeper than governance: The Dr. Dorval and Vivian Carter Family Birthing Center bears his parents’ names, and his father previously chaired the hospital’s OB-GYN department.
The pressures driving OB closures elsewhere are ones Mr. Carter understands well. Inadequate reimbursement tops his list.
“It is tied to the reimbursement that hospitals are receiving for the cost of something that I would argue is not a discretionary procedure,” he told Becker’s. “When someone has to have a delivery, they need medical care, and it should be reimbursed at a level that allows you to cover the cost of providing that care. And unfortunately, in many instances, that’s not the case.”
Litigation risk compounds those financial pressures, and Mr. Carter said the combination is pushing hospitals to shut down obstetrics units and redirect patients to resources that, in many cases, are much farther from their communities.
Declining birth rates have added another layer of difficulty across the Chicago market. Saint Anthony has held its ground nonetheless. At the center of the hospital’s strategy is a midwifery program that Mr. Carter traces to his own family history.
“We have one of the oldest programs of midwifery in the city,” he said. “It was started almost 20 something years ago by my dad when he was chair of the OB-GYN department here, and it’s something that we’ve maintained over the course of that period of time, and have allowed it to grow.”
The hospital now employs seven midwives, with tenures at Saint Anthony ranging from two to 21 years. That longevity reflects a care environment built to match the midwifery philosophy, Mr. Carter said.
“The concept of midwifery is that if at all possible, you’re trying to provide a natural birth. You don’t want to have to go to C-sections or some other intervention,” he said. “We culturally are very much focused on minimizing the interventions that may have to occur, and you don’t necessarily find that at every hospital.”
The results bear out the approach. Saint Anthony carries one of the lowest C-section rates in Chicago and one of the highest rates of vaginal delivery following a prior cesarean — both measures that run counter to standard practice at many hospitals.
A key driver of volume is Saint Anthony’s network of relationships with federally qualified health centers, or FQHCs, many of which run their own midwifery programs and direct patients to hospitals where that philosophy is shared.
“One of the things that we pride ourselves in is not only that we have a midwifery program, but we create an environment for the midwives to provide their services that are supportive of what they’re trying to do,” Mr. Carter said.
For other hospitals considering a midwifery model, he said the cultural commitment has to come before anything else.
“Initially — and this is a conversation that has to happen not just with the leadership of the hospital, but with your providers and your department chair and everyone else — we want to create a culture that will be inclusive and supportive of this type of service,” he said. “And then you need to start to develop relations with your FQHCs, many of whom run midwifery programs, to develop the relationship and the trust necessary for them to refer their mothers to your hospital. That’s not something that’s done overnight.”
On the workforce side, Mr. Carter acknowledged the competitive pressures facing independent hospitals.
“Any safety-net hospital has challenges around recruitment because we’re not necessarily in a position to meet the compensation demands of some of the bigger hospitals,” he said. “But we are offering something that’s somewhat unique for us, and I think that does appeal to a lot of nurses and midwives who want to support this type of approach to deliveries.”
The hospital has also invested in its physical environment. Mr. Carter said first-time visitors tend to be surprised by what they find.
“We’ve totally revamped our maternity floor,” he said. “We’ve made it much more welcoming. We created rooms where the family can all be together for the birth, all of which are intended to be supportive of the effort that we’re talking about here, and that, I think, is appreciated not only by the midwives but also by the mothers themselves.”
The labor and delivery program is closely linked to Saint Anthony’s pediatric services. The hospital is one of a small number of children’s hospitals on Chicago’s Southwest Side, a connection Mr. Carter sees as central to its broader mission.
“Our philosophy is to try to provide quality care from birth all the way through your geriatric years,” he said. “Knowing that you can come here and deliver your baby, and then also immediately start to engage with our pediatric department and get the child care that you need for your infant — I think is a big part of the overall philosophy that helps support not only the volume that we get here, but also the long-term retention of patients who basically utilize the services that we provide.”
