Financial Analysis of Rural Obstetric Care Hospitals

Access to obstetric services is declining in rural communities in the United States, with only 41.2% of rural counties having access to hospital-based obstetric care in 2022. 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. Finances are frequently cited as a primary reason for obstetric unit closure. As financial distress persists as a challenge for rural hospital viability, it is important to understand how the financial situation of rural hospitals may impact or be impacted by decisions around providing obstetric services and the financial context for maternity care provision in rural communities.

The purpose of this project is to describe the financial stability and hospital longevity of rural and urban hospitals before and after obstetric unit closure. Additionally, we will identify financial factors that contribute to decisions around obstetric service provision in rural communities in order to better understand the factors that lead to—or could prevent—obstetric unit closures.

This project is part of the Rural Maternal Health Data Support and Analysis Program (RMHD), which is a partnership between the University of Minnesota Rural Health Research Center and Mission Analytics Group, Inc.. It is funded by the Federal Office of Rural Health Policy (FORHP) within the Health Resources and Services Administration (HRSA).

Publications

• 2010-2022 County-Level Hospital-Based Obstetric Care Status
  Rural Maternal Health Data Support and Analysis Program, University of Minnesota Rural Health Research Center
  Date: 07/2025
  This data resource is a county-level dataset containing the county FIPS code, state, and an indicator of whether each United States county had hospital-based obstetrics care in each year, 2010-2022. It is available for download as an XLS file.