Essentia Health Services recently announced that it plans to end labor and delivery services at its hospital in Fosston, a town of 1,400 people in northwest Minnesota.
The closure of the delivery ward means that mothers in Fosston and surrounding towns will now have to travel 45 minutes west to Crookston or east to Bemidji to find an obstetric unit that delivers babies.
It’s the latest in a longstanding trend of rural hospitals shuttering their obstetrics departments in the face of staffing and other challenges. Twenty years ago, more than 110 hospitals in the state offered birth services, according to the Minnesota Department of Health. Today that number stands at 76, with the closures hitting especially hard in communities in the rural northern reaches of the state.
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In Grand Marais, on the North Shore, women face a two-hour drive to get to the nearest birthing center in Duluth. Mothers in Ely (pop. 3,200) need to drive an hour to get to Virginia after the local hospital ended delivery services in 2014. Virginia is also the nearest delivery hospital for residents of International Falls, a city on the Canadian border with a population of more than 5,000 people. It’s one hour and 45 minutes away by car.
Minnesotans living on reservations and tribal lands are especially likely to face difficulties in finding a nearby birthing hospital, as the map above shows. Infant mortality rates for Indigenous Minnesotans are more than double what they are for white babies, according to state data, and the maternal mortality rate is nearly 8 times higher.
Chartis, a private health care consulting firm, recently found that Minnesota had the nation’s highest number of rural obstetrics closures from 2011 through 2021, although this is partly because it has more rural hospitals than other states. A March of Dimes report found that 14% of Minnesota moms have to drive a half hour or more to reach a birthing hospital, compared to 10% nationwide.
When rural delivery wards close, “our research has shown increased risks of emergency room births as well as preterm births, especially in the more remote rural communities which are not adjacent to urban areas,” said Katy Kozhimannil, a University of Minnesota health policy professor. “We have also found that rural communities that lose obstetrics are less likely to offer other evidence-based services and supports for families, like childbirth education or lactation support.”
Rural hospitals in Minnesota have often cited staffing challenges as a driver of maternity ward closures. It can be expensive to keep staff and supplies on hand for procedures that happen infrequently.
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“For obstetric services the fixed costs of staffing, equipment, and facilities are difficult to cover with volume based revenues when facilities and clinicians have few pregnant patients,” Kozhimanill explained in an opinion published in BMJ last year. “This leads to workforce shortages and unit closures in more remote, less populated areas.”
Essentia Health in Fosston, for instance, only delivered 38 babies in the 12-month period ending in June of 2022, according to state data. The hospitals in the communities of Olivia and Granite Falls saw fewer than 20 deliveries in their most recently reported years. Both have since ceased offering those services.
Kozhimanill also noted that nearly half of American births are financed by Medicaid, which “reimburses at substantially lower rates than private insurers, so facilities and clinicians caring for lower income patients in remote rural areas face exceptional challenges in generating revenue for obstetric services.”
The closure of an obstetrics unit can become part of a self-perpetuating cycle of rural decline. Young families in need of maternal and infant care may decide to move elsewhere, shrinking the local economy and making it harder for the community to fund services for those who remain.
The March of Dimes recommends expanding Medicaid eligibility and coverage as a way to reverse these trends, but Kozhimanill says policymakers should think bigger and consider ambitious investments in community public health.
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“Policy solutions need to focus squarely on the structural injustices and systemic failures that have created and reproduced the statistics that alarm us,” she wrote last year. “As the closest place to give birth becomes further and further away for many people, these facts should no longer be surprising.”
BREWSTER, Minn. — Lots of hugs were shared, tears were shed and utter shock was witnessed as a rural Minnesota family was surprised with the Best Christmas Ever early Sunday afternoon, Dec. 14.
More than two dozen people caravaned behind a Brewster Fire Truck to deliver gifts to Austin and Stephanie VandeKamp and their 6-year-old daughter, Callee, in Brewster, Minnesota, in Nobles County.
Friends and family join Best Christmas Ever committee members for a group photo before leaving the Brewster Fire Hall to deliver gifts to the Austin and Stephanie Vande Kamp family Sunday afternoon, Dec. 14, 2025.
Julie Buntjer / The Globe
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“We just came to bring some joy to your life,” said Sue Hagen, one of the local coordinators for the nationwide nonprofit
Best Christmas Ever organization,
which surprises families who have experienced hard times. “Last year, with the loss of Jaelee, none of these gifts we’re bringing to you will ever replace her, but we just thought that your family deserved a little joy this Christmas.”
The Vande Kamps gave birth to their daughter, Jaelee, on Feb. 4, 2024. Shortly thereafter, Jaelee was diagnosed with a congenital heart defect, TAPVR (Total Anomalous Pulmonary Venous Return). She spent her first eight months in the cardiovascular intensive care unit at Children’s Minnesota in Minneapolis, where she had 10 surgeries and ultimately required continuous dialysis.
Stephanie didn’t get to hold Jaelee until she was 50 days old, and stayed with Jaelee for much of her hospitalization. When she did come home, Austin would go to the hospital to stay with their youngest daughter.
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They were finally able to bring Jaelee home on Sept. 23, 2024. Because she was dependent on respiratory support, someone had to be awake with her 24/7, so Stephanie got very little sleep, family friend Ashley Prins detailed in the nomination letter she sent to Best Christmas Ever.
People wait in line bearing gifts to deliver to the Austin and Stephanie Vande Kamp family Sunday afternoon, Dec. 14, 2025, in rural Brewster.
Julie Buntjer / The Globe
Jaelee died unexpectedly on Dec. 9, 2024, while attending regular follow-up appointments in Sioux Falls, South Dakota. Jaelee’s death compounded the loss the family was still feeling from the sudden death of Stephanie’s dad from a heart attack on Easter morning 2022.
“The community just rallies around a family and they don’t even know who it will be,” Hagen said, noting that Bedford Industries, Sanford Worthington and District 518 were among employers who stepped up alongside community members to “help uplift a family.”
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Locally, the Best Christmas Ever program is sponsored by the Astrup Family Foundation, owner of Sterling Pharmacy stores, which provides $5,000 toward a life-changing gift for a local family who has fallen on hard times through no fault of their own. Business partners included Worthington Federal Savings Bank and Runnings who, along with Sterling Pharmacy, had giving trees set up at their businesses in recent weeks to accept gifts and monetary donations for the recipients.
The VandeKamps were nominated for the Best Christmas Ever program by family friend Ashley Prins.
“I would love to make this year a joyous season again for them in regards to holidays and I would love to see the three of them be able to get away on a vacation and enjoy their time together as they missed out on so much of that during this life struggle,” Prins wrote in her letter.
Stephanie, left, and Austin VandeKamp share a look as daughter, Callee, stands between them as they listen to Sue Hagen talk about the Best Christmas Ever program Sunday afternoon, Dec. 14, 2025.
Julie Buntjer / The Globe
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In addition to a mound of neatly wrapped gifts — most of which were for Callee — the family was presented with a monetary gift of $7,403.07. The local Best Christmas Ever committee will work with the family on how the gift may be used.
“I don’t know what to say,” Austin said after accepting the money.
“Merry Christmas,” replied Chad Nixon, representing Worthington Federal Savings Bank.
Callee opened her largest box, which contained a child-sized recliner just for her, as well as two stuffed animals to match the chair. Stephanie and Austin received Minnesota Twins jerseys reflecting their favorite current Twins players.
Among the people on hand Sunday were last year’s recipients, the Adrian and Melissa Gonzalez family, of Worthington. The Gonzalezes lost their son, Emmitt, to cancer in September 2023.
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Hagen also presented the family with over $1,000 in gift cards to local businesses, and noted that donations are still coming in. The Best Christmas Ever committee will meet again with the Vande Kamps after Christmas, she said.
The VandeKamps were completely surprised by the gesture — after admitting a bit of fear as to why a fire truck with lights on and siren blaring pulled into their rural Brewster farmyard.
“I thought right away my barn was on fire, my lambs were running everywhere, then I saw a big wad of cars and I thought, ‘what’?” Austin said.
Julie Buntjer became editor of The Globe in July 2021, after working as a beat reporter at the Worthington newspaper since December 2003. She has a bachelor’s degree in agriculture journalism from South Dakota State University.
So Minnesota: Lego King of Minneapolis builds Minnesota landmarks one brick at a time
Many kids will find Lego sets under the Christmas tree this holiday season, but the popular toy isn’t just for children.
Jeff Esler fell in love with Legos as a child, and that love affair has never ended.
“I am the Lego king of Minneapolis,” Esler said. “So my friends call me.”
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A decade ago, Esler immortalized Nye’s Polonaise Room in Legos and posted it on Facebook.
“That one, it kind of went really viral,” Esler said. “I think I got 100,000 shares.”
Esler’s fame grew after he went on to use toy bricks to build mini masterpieces of Minnesota landmarks.
“I did Matt’s, and then I did Gluek’s,” Elser said. “I did the Frank Lloyd Wright gas station in Cloquet. Then, probably the Split Rock Lighthouse. The Grain Belt sign.”
Each project costs from a few hundred to a few thousand dollars. They take a ton of bricks and days to build. Esler has sold some models and given others away.
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“I do the landmarks, because they click with people,” Esler said.
Esler plans to keep building some of Minnesota’s most recognizable places one brick at a time.
Federal prosecutorsannounce indictments against two Philadelphia men they say submitted up to $3.5 million in fake and inflated bills to Minnesota Medicaid programs, WCCO-TV reports. “Minnesota has become a magnet for fraud, so much so that we have developed a fraud tourism industry,” U.S. Attorney Joseph Thompson said.
State Rep. Kristin Robbins alleges – without sharing a name or other evidence – that the Minnesota Department of Human Services paid state money to a Feeding Our Future defendant while they were awaiting trial, the Minnesota Reformer reports. Robbins, who chairs a legislative fraud oversight committee and is running for governor, says she has collected hundreds of whistleblower tips, but she has not shared them with the department’s inspector general.
The state has suspended or delayed payments to several social service providers as part of an effort to catch and prevent fraud, and now one of those providers says the crackdown had deadly consequences, KARE 11 reports. A service provider says a vulnerable adult client was found dead in his St. Paul apartment after the state froze payments that had been covering his care.
Rolling Stone writer Stephen Rodrick, who spent time with Melissa Hortman while covering Minnesota Gov. Tim Walz during the 2024 presidential campaign, writes about the life of the late Minnesota House Speaker in a 7,000-word profile based on interviews with dozens of family, friends and colleagues.
