DELAWARE — When Isabella Migliore learned OhioHealth plans to close Grady Memorial Hospital’s maternity unit on July 31, she said it felt like “a punch in the face.”
The 25-year-old Powell resident delivered her daughter at Grady last year after initially questioning whether she wanted to give birth there at all.
She told Delaware City Council at its June 22 meeting that she’d make the same choice again.
“After I had my daughter, I almost died on the table,” Migliore said. “She ended up breaking her collarbone on the way out. If Grady wasn’t here, I don’t know what would have happened to my daughter.”
As someone with an extreme fear of hospitals, Migliore said the nurses in Grady’s labor and delivery unit made her feel at home during one of the most frightening moments of her life.
“They made you feel like they were your family,” she said. “And if it gets taken away, I feel like a lot of our mothers are not going to feel safe in Delaware anymore.”
Migliore’s story highlights a question at the center of the debate over Grady’s maternity unit.
OhioHealth says relatively few Delaware County families are choosing Grady for childbirth. During the last fiscal year, they said fewer than 10 percent of babies born to Delaware County families within the OhioHealth system were delivered at Grady.
But many of the nurses, patients and healthcare advocates opposing the closure argue that birth numbers alone do not capture the value of maintaining local labor and delivery services.
Low utilization or unmet demand?
OhioHealth said most Delaware County families already choose to give birth somewhere other than Grady Memorial Hospital.
According to the health system, deliveries at Grady have declined 23 percent since 2019, and the hospital delivered approximately 265 babies in 2025.
By comparison, state data shows 2,269 babies were born to Delaware County residents in 2025. The U.S. Census Bureau estimated that 2,476 women in Delaware County gave birth in 2024.
OhioHealth says Grady’s declining numbers reflect changing patient preferences and a broader shift toward higher-level maternity facilities.
“We are seeing a higher percentage of high-risk births due to a declining birth rate, delayed pregnancies, and increasing rates of hypertension and diabetes in women,” said Jason Melillo, MD, vice president of OhioHealth’s Women’s and Reproductive Health Clinical Service Line.
“Women are choosing higher level maternity sites for delivery.”
Within the OhioHealth system, Grady is classified as a Level I maternity hospital, meaning it is designed to care for healthy pregnancies and routine deliveries. Patients with higher-risk pregnancies are often referred to larger facilities with advanced maternal and neonatal capabilities.
OhioHealth said many families already choose to deliver at OhioHealth Riverside Methodist Hospital, OhioHealth Dublin Methodist Hospital and OhioHealth Marion General Hospital.
But Angel Smith, a registered nurse at Grady Memorial, questioned whether declining deliveries tell the full story.
“I’ve also heard it said that only a small percentage of Delaware County babies are born at Grady, but I think it’s important to ask why,” she told Delaware City Council on June 22.
Smith said many patients have told her they would have preferred to deliver in Delaware if additional maternity resources had been available locally.
“The desire for local maternity care was here,” she said. “The desire for expanded services was here.
“The community has been asking for investment, not less access.”
Smith also noted Grady serves patients beyond Delaware County.
“One of those surrounding counties is already considered a maternity care desert,” she said. “So my question is, what happens to those mothers and babies now? What happens when the care moves even farther away?”
What options remain?
If Grady’s labor and delivery unit closure continues on July 31, Delaware County families will still have several options for prenatal care and childbirth.
OhioHealth has said obstetric and gynecological practices in Delaware, Lewis Center and Jerome will remain open, allowing women to continue receiving prenatal and postpartum care close to home.
“Obstetrics include pregnancy, childbirth, and postpartum care,” the health system said in a June 23 statement to Delaware Source.
“OhioHealth is keeping pregnancy and postpartum care locally. Only labor and delivery, which has declined 23 percent since 2019, is changing.”
The health system previously said Grady Memorial’s emergency department teams are “fully equipped, trained, and prepared to safely support and deliver babies for any patient who arrives in labor or requires an emergency delivery.”
But if Grady’s maternity unit closes, there would no longer be a hospital in Delaware County where women can give birth.
There are also no freestanding birth centers operating in Delaware County, which are licensed healthcare facilities that provide pregnancy, delivery and immediate postpartum care for low-risk mothers. There are only a handful of such facilities in the state of Ohio.
As a result, some families have begun exploring home birth.
Linsey Griffith, a certified professional midwife and Delaware City Council member, said she has seen approximately a 20-percent increase in inquiries since OhioHealth announced the closure of Grady Memorial’s maternity unit.
According to the Cleveland Clinic, a midwife is a healthcare provider who provides obstetric and gynecological services, including prenatal care, childbirth and routine gynecological care. Midwives specialize in uncomplicated obstetric and gynecological care.
Griffith noted that many of the patients who qualify for home birth are also the kinds of patients Grady was designed to serve as a Level I maternity hospital.
“Grady closing opens up clients for me personally,” Griffith said. “But Grady closing makes birth less safe for an entire county. I cannot be the only person in this county caring for pregnant people.”
Griffith said interest in home birth has grown in recent years, both locally and nationally. Part of that increase occurred during the COVID-19 pandemic, when some families sought alternatives to hospital births.
But she cautions against viewing home birth as the default choice if a hospital birth is not available.
“Home birth is for low-risk families with uncomplicated pregnancies and infants with no known risk factors,” she said.
“I don’t want people coming to home birth out of fear and desperation. I want them making an informed choice that’s what’s best for their family.”
Griffith emphasized that most births proceed without major complications and that childbirth is a normal physiological process.
But she cautioned that emergencies can develop quickly and without warning. She said midwives also routinely refer patients elsewhere when a pregnancy falls outside their scope of care.
“It’s one of those situations where birth goes great until it doesn’t,” she said.
“The risks are incredibly low. But the consequences are catastrophic.”
Beyond labor and delivery
Griffith also questioned what happens over time if babies are no longer being delivered in Delaware County.
Physicians currently practicing in Delaware often have delivery privileges at other OhioHealth hospitals in addition to Grady, Griffith said.
The larger question, she argued, is whether the closure could make it more difficult to recruit and retain women’s healthcare providers in Delaware County.
“If there are no deliveries happening in Delaware, does it make sense for those doctors to keep the office open?” Griffith said. “I don’t have the answer to that question.”
The Ohio Nurses Association (ONA), which does not represent OhioHealth employees but frequently advocates on healthcare policy issues, said it has seen the consequences of similar maternity unit closures elsewhere.
“It’s lives. It’s complications,” Rick Lucas, RN, president of the ONA, told Delaware Source. “Even if we’re not talking about death, we’re talking about complications that have long-term impact.”
Lucas also warned that obstetric emergencies can place additional strain on the rest of a hospital.
“If the ER is trying to figure out what to do with mom and baby, they’re not taking as good a care or have as many resources for a heart attack that came in, the stroke that came in, and the car accident that happened down the road,” he said.
Displacing births from Grady Memorial will also put a strain on the other hospitals that must absorb them, Lucas said.
“Those areas are already overcrowded and already stretched thin,” he said.
“Taking an entire community and displacing them into that, we’re just gonna have more people giving birth or fetal demise in triage rooms, in hallways or, God forbid, the parking lot or State Route 23.”
