In recent years, rural obstetric unit closures have continued to occur in communities across the United States. There has been a steady decline in rural obstetric care access in the United States. In 2014, more than half of rural counties had no hospital that provided obstetric services. These trends continued from 2014-2018, with further services losses disproportionately affecting the most remote rural areas of the U.S. The loss of obstetric care in rural communities adversely affects maternal and infant health and is associated with fewer evidence-based services and supports for birthing people and families. Rural counties that lose hospital-based obstetric services experience higher rates of births in hospital emergency rooms, and in rural counties that are not adjacent to urban areas, those that lost obstetric services saw increases in preterm birth rates. Preterm birth is a leading cause of infant mortality, and data show higher rates of infant mortality for rural infants, compared with urban infants.

The goal of this project was to update prior research to include the latest information on the loss of hospital-based obstetric services in rural U.S. counties. Updated information on obstetric care access and obstetric unit closures in rural communities is essential to inform clinical and policy efforts to address persistent maternal and infant health concerns.

Publications

• Access to Maternity Care: Challenges and Solutions for Improving Equity Across U.S. Communities
  Journal Article
  University of Minnesota Rural Health Research Center
  Date: 11/2024
  This review summarizes the most up-to-date research on maternity care access and health outcomes associated with obstetric unit closures and traveling long distance to receive care. It also offers potential strategies to combat declining access and improve health outcomes.
• Information for Rural Stakeholders About Access to Maternity and Obstetric Care: A Community-Relevant Synthesis of Research
  University of Minnesota Rural Health Research Center
  Date: 09/2024
  This document aims to inform rural stakeholders about challenges related to access to and quality of hospital-based childbirth care in rural U.S. communities.
• Loss of Hospital-Based Obstetric Services in Rural Counties in the United States, 2010-2022
  University of Minnesota Rural Health Research Center
  Date: 07/2024
  The purpose of this infographic is to show the loss of hospital-based obstetric services in rural counties from 2010 to 2022, and how this differs by rural county type (micropolitan vs. noncore).
• Obstetric Care Access at Rural and Urban Hospitals in the United States
  Journal Article
  University of Minnesota Rural Health Research Center
  Date: 12/2024
  Maternal mortality is on the rise in the U.S., while access to maternal health services continues to decline. This study examines the losses and gains of obstetric care at hospitals in the United States from 2010 to 2022.