Safe Obstetric Care Access for All Rural Residents: Minimum Standards for Clinical, Workforce, and Financial Viability of Rural Obstetric Units

Research center:
Lead researcher:
Project funded:
September 2020
Anticipated completion date:
August 2021

The health of rural mothers and infants is a growing concern across the U.S. Access to care during pregnancy and childbirth is declining for rural residents, and both maternal and infant morbidity and mortality are higher for rural families compared to urban families. Both limited care access and poor outcomes among rural residents are cause for concern in the broad national context of rising rates of maternal morbidity and mortality and maternity care quality. This project aims to address the nexus of these challenges: minimum standards for safe maternity care in rural communities.

Prior research and stakeholder input indicate that the main challenges rural hospitals face in providing services during pregnancy and childbirth can be categorized into four groups: local context, clinical safety, workforce, and financial. This project will survey rural hospitals and systematically assess minimum criteria currently present when providing obstetric services in these categories. It will also explore potential policy options to ensure that financial and workforce constraints do not impede rural obstetric care access and that clinical safety is supported through policies and resources.


  • Characteristics of Rural and Urban U.S. Hospitals Based on Obstetric Services
    University of Minnesota Rural Health Research Center
    Date: 04/2021
    This infographic provides an overview of characteristics of rural and urban hospitals in the United States that provide obstetric services, as well as rural hospitals that recently closed their obstetric units.
  • Rural and Urban Hospital Characteristics by Obstetric Service Provision Status, 2010-2018
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 04/2021
    The purpose of this policy brief is to illustrate the differences between urban and rural hospitals that provide obstetric services by their size, capacity, location, and community characteristics, as well as to compare these factors between rural hospitals with obstetric services and those that recently closed their obstetric units.