Rural Obstetric Unit Closures

Research center:
Lead researcher:
Research staff:
Project funded:
September 2023
Anticipated completion date:
August 2024

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 is 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.