A report published by the Rural Health Research Center at the University of Minnesota shows a widespread lack of hospital-based obstetric services in rural counties. As stated in the report’s executive summary, this has national and local implications:
Access to hospital-based obstetric care declined from 2010-2013, particularly in rural areas, and access varies across US states. Loss of hospital-based obstetric services is associated with increased potential risks for maternal and infant health.
Some of the key findings of the report are:
- By 2023 60% of rural counties lacked hospital-based obstetric services
- Over 50% of all U.S. counties lacked hospital-based obstetric services in 23 states.
- In 20 states over 75% of the counties that lacked hospital-based services in 2023 were rural counties
- In 12 states, 100% of counties that lost hospital-based obstetric services between 2010 and 2023 were rural counties
- 76% of counties without a town with more than 10,000 residents did not have hospital-based obstetric services
- In seven states, Florida, Georgia, Illinois, Louisiana, North Dakota, Oklahoma and Tennessee, over 90% of rural counties without a town with more than 10,000 residents lacked hospital-based obstetric services
- Over 75% of rural counties lacked hospital-based obstetric services in four states, Florida, North Dakota, Virginia and West Virginia
The report includes detailed maps and graphs showing the availability of hospital-based obstetric services in all 50 states.
Although not discussed in the report, many analysts fear that deep cuts in Medicaid funding and the expiration of the expanded subsidies under the Affordable Care Act as a result of the omnibus tax and spending cut bill, as well as low reimbursement rates and inappropriate denials further reducing reimbursement, will force more hospitals, particularly in rural areas, to either close or to shutter costly services such as obstetric services in the coming years.
The University of Minnesota report is linked here.