The health of rural birthing people and their families is an important clinical, policy, and community priority across the United States. Compared with urban birthing people, rural residents experience higher rates of infant mortality, maternal mortality, and severe maternal morbidity. Rural residents who are Black, Indigenous, and People of Color have the highest maternal mortality and infant mortality rates in the country. At the same time as mortality and morbidity are rising, a steady trend of rural hospital and maternity unit closures has reduced access to care for pregnant rural residents. Still, some rural communities thrive, providing high-quality support to pregnant people, parents, infants, and families. This case series highlights examples from racially diverse rural communities, where hospitals and health systems with obstetric units strive to meet patient needs and provide evidence-based, supportive services during pregnancy, childbirth, and the postpartum period.