In July, the ministry received a proposal from experts in obstetrics from the United Kingdom and internationally to assess the possibility of developing a new low-risk childbirth care model based on KGN.
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However, at the same time, the Families’ initiative group “Save Kaunas Christian Maternity Hospital” received information that KGN employees who do not intend to transfer to another LSMU Kaunas hospital department were offered to terminate their employment relationships a month earlier, according to a press release.
The ministry will review the maternity hospital issue again
In recent months, the transfer of obstetric services from KGN was presented as a decided matter. According to the LSMU Kaunas hospital restructuring plan, births at Miško Street are planned to be discontinued and from October 1, obstetric services will be transferred to the hospital department on Josvainiai Street. The restructuring is based on the decreasing number of births and financial arguments.
After news about the planned restructuring spread, there was widespread public resistance. An electronic petition to save Kaunas Christian Maternity Hospital gathered more than 13,000 signatures, families and various organizations repeatedly appealed to the decision-making institutions, but until the change in the ministry leadership, the decision remained unchanged.
The new leadership of the Ministry of Health returned to the KGN issue. Health Minister Linas Kukuraitis included the KGN issue among his first tasks, met with the management of LSMU Kaunas hospital, and publicly announced that the ministry is looking for a solution that would preserve KGN’s mission, the environment important to families, and choice.
The minister also stated that, in his assessment, the decisions made so far are not balanced, and transferring services risks losing some specialists and the team’s accumulated experience.
Questions also arise about how thoroughly the consequences of the restructuring and alternatives have been assessed. When the Families’ initiative group requested impact assessments and other documents justifying the decision, LSMU Kaunas hospital refused to provide them, citing lack of legal grounds. The public was also not presented with calculations allowing evaluation of whether the new activities planned in the KGN premises would be economically more beneficial, not duplicate services provided in other hospital departments, and help reduce the hospital’s overall loss.
While a solution is sought, there is a risk of losing the team
Meanwhile, the Families’ initiative group “Save Kaunas Christian Maternity Hospital” received information that KGN employees who do not plan to continue working in another LSMU Kaunas hospital department were offered to terminate their employment already on August 30 – a month earlier than previously planned end of their work at KGN, with an offer to pay September’s salary as well.
The Families’ initiative group asked LSMU Kaunas hospital to clarify the situation. The hospital emphasized employees’ freedom of choice and stated it does not comment on individual employment relationships but did not specifically deny that such an offer was made. The Ministry of Health, as one of the hospital’s shareholders, was also informed about the situation, requesting to ensure that no actions accelerating the team’s disintegration are taken while solutions for KGN’s future are sought.
If the currently planned transfer of childbirth services from KGN is implemented, only a small part of the current childbirth team would move to the Josvainiai St. department. According to data held by the Families’ initiative group, only 4 out of 14 KGN midwives intend to transfer to the LSMU Kaunas hospital Josvainiai St. department, and among the 12 KGN obstetrician-gynecologists, the total workload of transferring specialists will not reach 2 full-time positions.
Such numbers hardly align with the publicly declared goal of preserving KGN staff and the good practice they have created as much as possible during the reorganization. In April, the Seimas Health Committee, supporting the KGN reorganization, identified the preservation of staff, their competencies, and the created service delivery practice as one of the key priorities in its decision.
International experts propose assessing a new childbirth care model
In July, a proposal was submitted to both LSMU Kaunas hospital shareholders – the Ministry of Health and the Lithuanian University of Health Sciences – prepared by experts from St. George’s University of London, representatives of the European network of midwife-led units, and a senior Lithuanian midwife working in the United Kingdom to assess the possibility of developing an independent midwife-led childbirth unit based on KGN, dedicated to low-risk pregnancies and births.
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This model would allow the use of competencies and infrastructure already accumulated by KGN, while adapting the international practice of midwife-led units to Lithuanian conditions.
This direction also aligns with the latest World Health Organization (WHO) guidelines. WHO urges countries to expand midwife-led care models, including midwife-led birth centers for low-risk women, emphasizing continuity of care, woman-centered care, and positive birth experience.
Similar trend across Lithuania
Over the past decade, about 14 obstetric departments in Lithuania have ceased providing childbirth services, and childbirth care is increasingly concentrated in larger hospitals. The decreasing number of births and the financial cost of maintaining smaller departments have become some of the main arguments for network restructuring.
Some institutions that no longer provide childbirth services today were significantly modernized earlier with state and international funds. Lithuanian and Swiss cooperation programs invested in infrastructure, medical equipment, specialist competencies, and improving patient experience.
However, good patient evaluations did not ensure the survival of childbirth locations: the highly valued Trakai obstetric department and P. Mažylis maternity hospital no longer accept births, and now it is planned to discontinue them at the highly regarded KGN as well. This raises a broader question about the criteria used to assess the long-term value of such investments.
It is also important to evaluate not only individual decisions but their cumulative impact on the entire obstetric system. One service transfer may seem rational, but the accumulated effect of many such decisions can significantly change geographic accessibility, family choice, patient experience, and the diversity of care models.
Demographic crisis – an argument to narrow choice or seek new solutions?
Declining birth rates in Lithuania are a real and serious challenge. However, according to the Families’ initiative group, during a demographic crisis, it is worth asking not only how much it costs to maintain different childbirth locations but also what kind of childbirth care system the state wants to provide for families and how much real choice should remain in it.
Consistently concentrating births in large hospitals reduces the possibility to choose a different environment and care model.
Therefore, the international experts’ proposal is important not only for KGN – it opens a discussion on whether, alongside large obstetric centers in Lithuania, a separate, safe, and economically sustainable low-risk childbirth model could operate – one that preserves choice and at the same time responds to demographic and financial challenges.
The new Ministry of Health leadership’s decision to return to the KGN issue has given families hope that the discussion is not over. The ministry has publicly confirmed that the search for solutions continues and that family choice and the experience created by KGN are values worth preserving.
Until the evaluation of alternatives is completed, the most important thing is not to lose what cannot be quickly restored later – the KGN team, its competencies, and the ability to implement an alternative solution.
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