Safe Obstetric Care Access for All Rural Residents: Minimum Standards for Clinical, Workforce, and Financial Viability of Rural Obstetric Units

Research center:
Lead researcher:
Project funded:
September 2020
Project completed:
December 2022

The health of rural mothers and infants is a growing concern across the U.S. Access to care during pregnancy and childbirth is declining for rural residents, and both maternal and infant morbidity and mortality are higher for rural families compared to urban families. Both limited care access and poor outcomes among rural residents are cause for concern in the broad national context of rising rates of maternal morbidity and mortality and maternity care quality. This project aimed to address the nexus of these challenges: minimum standards for safe maternity care in rural communities.

Prior research and stakeholder input indicate that the main challenges rural hospitals face in providing services during pregnancy and childbirth can be categorized into four groups: local context, clinical safety, workforce, and financial. This project surveyed rural hospitals and systematically assessed minimum criteria present when providing obstetric services in these categories. It also explored potential policy options to ensure that financial and workforce constraints do not impede rural obstetric care access and that clinical safety is supported through policies and resources.