In recent years, rural obstetric unit closures have continued to occur in communities across the U.S., and COVID-19-related policies have attempted to address workforce challenges, yet burnout has exacerbated clinician shortages. State scope of practices laws, as well as Medicaid and other insurance and payment policies, have a profound impact on access to midwifery care and midwife-attended births. As more rural hospitals have closed their obstetric units, as scope of practice and payment policies have changed, and as the COVID-19 pandemic has affected the clinician workforce, it is important to investigate the current status of midwifery care in rural communities and to describe rural-urban differences.

The goal of this project is to describe the current midwifery workforce at rural hospitals that provide obstetric care and to assess rural-urban differences in midwifery care at the time of childbirth.