Wilmington, Del.-based Nemours Children’s shared plans in early December to open an institute for maternal-fetal health aimed at improving care for expectant mothers facing serious fetal diagnoses.
The Institute for Maternal Fetal Health at Nemours Children’s first location is set to open in early 2026 at Nemours Children’s Hospital in Wilmington. It will offer advanced quaternary-level services, like multimodal fetal imaging, prenatal diagnostics, fetal intervention, genetic evaluation and complex neonatal care.
The institute comes as maternity care services nationwide continue to face significant challenges, with many hospitals closing labor and delivery units due to financial pressures, staffing shortages and declining birth volumes, which limits access to care in many communities. Becker’s has reported on 29 maternity service closures in 2025 alone.
Becker’s connected with Nemours Children’s Health President and CEO R. Lawrence Moss, MD; Executive Vice President and CFO Caswell Samms III; and Julie Moldenhauer, MD, inaugural executive director of the Nemours Institute for Maternal–Fetal Health, to learn how the institute aims to strengthen the system’s maternity care strategy and position Nemours as a provider of specialized maternal and neonatal care over the long term.
Editor’s note: Responses have been lightly edited for clarity and length.
Q: How will this institute strengthen your system’s overall maternity care strategy amid national service cuts?
Dr. R. Lawrence Moss: The Institute for Maternal Fetal Health at Nemours Children’s strengthens our maternity care strategy at a time when access to maternal-fetal services are declining nationally. By expanding access to advanced diagnostics and interventions, we’re ensuring families have options for highly specialized care when and where they need it.
Early diagnosis of fetal anomalies is critical. By identifying issues sooner, we can best prepare families for the road ahead, while providing crucial emotional and social support. We can then provide optimal care for the baby before or immediately after birth. This approach ensures that care is not only clinically excellent but also holistic, addressing both medical and psychosocial needs.
This reflects our commitment to Whole Child Health—starting well before birth. We combine leading-edge fetal interventions with comprehensive family support.
Q: What measurable outcomes are you prioritizing in the first year to demonstrate impact for high-risk mothers?
RLM: Our top priority is improving early access to expert care. We are focused on increasing timely referrals and delivering advanced diagnostics, including high-resolution imaging, genetic evaluation, and multidisciplinary counseling. We are also measuring family engagement—ensuring that education and support are integrated throughout the process. These efforts will reduce complications and improve outcomes for both mothers and babies.
Q: How are you ensuring this model can be scaled or replicated across your broader system footprint?
RLM: Scalability is built into the Institute’s design. From recruiting top clinical talent to standardizing protocols and workflows, every decision supports future expansion. Our goal is to replicate this model across our system, extending access to specialized maternal-fetal care wherever families need it. This strategic approach ensures consistency, quality and sustainability as we grow.
Q: How does investing in a maternal–fetal health institute fit into your long-term strategy for stabilizing essential services in markets facing maternity care closures?
Caswell Samms III: Nemours views our Institute for Maternal Fetal Health not as a traditional obstetrics expansion, but as a system stabilization strategy. With maternity units closing across the country, especially in rural and safety-net areas, high-risk pregnancies still occur, but care becomes fragmented and delayed. Nemours aims to move upstream by identifying risks earlier and serving as a regional anchor for high-acuity maternal and neonatal care. This approach stabilizes access today while protecting essential pediatric services tomorrow by creating a predictable pipeline into NICU and complex pediatric care. In short, the focus is on continuity from pregnancy through childhood, not chasing delivery volume.
Q: What financial safeguards are you putting in place to ensure this institute can remain resilient even if maternity volumes continue to shift nationally?
CS: The Institute is designed to avoid dependence on delivery volume alone. The model is diversified, offering high-risk maternal consults, fetal diagnostics, advanced imaging, neonatal services, and longitudinal pediatric care, much of it delivered through regional partnerships and telehealth rather than large inpatient expansions. Nemours applies capital discipline by phasing investments, keeping them asset-light, and tying them to referral capture and downstream pediatric performance instead of open-ended inpatient growth. Additionally, the institute aligns with Medicaid global budget, state, and payer priorities around maternal mortality. Nemours will create improved access and quality, while creating durability through value-based arrangements. This reduces exposure to fee-for-service volatility.
Q: What ROI or value metrics will you use to evaluate success beyond traditional revenue measures?
CS: While revenue is important, Nemours measures success across four dimensions. System economics focuses on downstream pediatric contribution margin, NICU utilization, and reduced acuity through earlier intervention. Cost avoidance includes fewer emergency transfers, shorter NICU stays, and lower total cost per maternal–child episode. Access and equity emphasize expanding care into maternity deserts and improving maternal and neonatal outcomes. Strategic resilience centers on stronger state partnerships, payer alignment, and long-term stability of essential pediatric services. For Nemours, ROI is about reducing risk, protecting access, and strengthening the system’s financial foundation, not maximizing delivery counts. Maternal fetal health is no longer just an obstetrics issue; it’s a pediatric sustainability issue. By investing upstream, Nemours can deliver better outcomes, lower system risk and ensure children have access to the care they need long after birth.
Q: How will you build and lead a multidisciplinary team that can reliably deliver safe, coordinated care for mothers and babies with complex needs?
Dr. Julie Moldenhauer: At Nemours Children’s, we believe that Whole Child Health begins well before birth. Our goal is to develop a comprehensive, high-level prenatal diagnosis, fetal intervention and complex delivery program that approaches care through a holistic, family-centered lens. We are committed to building out this vision to ensure that we are not only providing expert medical care, but also supporting the patient and family through an incredibly stressful journey where we will be right next to them for guidance and encouragement. Certainly, this approach requires a large team with varying aspects of expertise that includes fetal imaging, genetic counseling, psychosocial services, obstetrical care, anesthesia, neonatology and pediatric subspecialty care.
Q: What steps are you prioritizing to ensure families retain access to high-quality maternal–fetal care at a time when many hospitals are reducing or closing these services?
JM: We are committed to providing patients and families access to high-level maternal, fetal and neonatal care from diagnosis to delivery and well beyond. Our mission at Nemours Children’s is to create the healthiest generations of children. In order to accomplish this, we feel strongly that supporting families through their pregnancy journey is a key aspect to achieve this goal. In this light, we are starting as early as possible. Our commitment to patients, families and our referring physicians is unwavering.
Q: How will the institute partner with community clinicians and regional hospitals to strengthen safety and continuity of care throughout pregnancy?
JM: It is imperative to us that we create strong partnerships with our referring physicians and community hospitals; collaborative care is essential for an optimal outcome for these complex pregnancies. We aim to provide a holistic family-centered style of care for patients and families in addition to excellence in medical care. We see ourselves as an extension of the care that our patients receive “close to home,” and we want to build on that, supporting patients and referring physicians. For many patients, the care paradigm will be a co-management style with their local physicians, and they will largely be able to continue with their care close to home. For some patients whose baby may have a particularly complex diagnosis, delivery in the Advanced Delivery Unit would provide the optimal neonatal transition of care with the availability of multidisciplinary neonatal and pediatric subspecialists. If this is the case, we understand how challenging and stressful this can be on a family, and we provide psychosocial support to help them.
