As rural hospital and obstetric unit closures continue to affect rural communities across the U.S., little is known about the consequences of these closures in terms of access to maternity care and outcomes of childbirth for women and infants. Data to inform policy efforts are needed, as no current research documents the county-level effects of the loss of obstetric services on maternity care, location of childbirth, or birth outcomes. Further, little is known about the strategies rural women use to obtain maternity care in the wake of a closure and the effects of a closure on clinicians and communities. This project will examine the relationship between closure of an obstetric unit or hospital and maternity care and outcomes of childbirth in rural U.S. counties including prenatal care, distance to delivery hospital, out-of-hospital birth, and infant health outcomes.

Publications

• Access to Obstetric Services in Rural Counties Still Declining, With 9 Percent Losing Services, 2004-14
  Journal Article
  University of Minnesota Rural Health Research Center
  Date: 09/2017
  Providing access to obstetric care in rural areas is a growing concern. By 2014, about 54% of rural counties in the United States did not have hospital obstetric services.
• Association Between Loss of Hospital-Based Obstetric Services and Birth Outcomes in Rural Counties in the United States
  Journal Article
  University of Minnesota Rural Health Research Center
  Date: 03/2018
  This study examines whether the loss of obstetric services in hospitals in rural U.S. counties led to changes in childbirth outcomes or locations.
• Challenges Related to Pregnancy and Returning to Work After Childbirth in a Rural, Tourism-Dependent Community
  University of Minnesota Rural Health Research Center
  Date: 02/2018
  This case study highlights challenges related to pregnancy and returning to work after childbirth in a rural, tourism-dependent community in Minnesota.
• Closure of Hospital Obstetric Services Disproportionately Affects Less-Populated Counties
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 04/2017
  This policy brief describes the scope of obstetric unit and hospital closures resulting in loss of obstetric services in rural U.S. counties from 2004 to 2014.
• State Variability in Access to Hospital-Based Obstetric Services in Rural U.S. Counties
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 04/2017
  This policy brief describes state-level variations in 1) the availability of hospital-based obstetric services, and 2) the scope of obstetric unit and hospital closures resulting in the loss of obstetric services in rural U.S. counties from 2004 to 2014.