Overcoming Barriers to Providing Rural Obstetrical Training for Physicians

Research center:
Lead researcher:
Project funded:
September 2020
Project completed:
March 2023

Rural communities face diminishing availability of obstetrical (OB) services. Nearly a third of rural counties in 2019 had no OB clinicians. Family physicians are the most common health professional providing rural OB care, but more than half of rural counties had no family physicians who delivered babies in 2019, and this number is declining. Delivery by family physicians is associated with lower rates of cesarean section births, indicating that this workforce is important not only to increase rural access to OB care, but also to improve quality and reduce costs. Meanwhile, the U.S. is experiencing a national shortage of obstetricians and gynecologists (OB-GYNs), again more acutely in rural areas. How widespread rural OB training is and how expansion of this training can best be supported are not well understood.

This study described the availability, characteristics, and output of rural OB training programs, including family medicine residencies and OB fellowships as well as OB-GYN. This study identified barriers, facilitators, and solutions to support rural OB training. Study findings may help policymakers and rural health professional educators develop new initiatives to help ensure the availability of a robust rural OB workforce.


  • Understanding and Overcoming Barriers to Rural Obstetric Training for Family Physicians
    Journal Article
    WWAMI Rural Health Research Center
    Date: 03/2023
    Family physicians are the most common health professional providing rural obstetric (OB) care, but the number of family physicians practicing OB is declining. This mixed-methods study aimed to inform policy and practice solutions to address the training landscape and inform sustainable initiatives for rural family medicine obstetrical training.
  • Understanding and Overcoming Barriers to Rural Training in Family Medicine Obstetrics Fellowships
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 06/2023
    This policy brief describes the results of a survey on the characteristics and challenges faced by rurally oriented family medicine obstetrics fellowship programs. All survey respondents reported their programs had a mission to train family physicians for rural practice, yet less than one-third of programs reported they required rural training.