This study aimed to analyze the scope of obstetric unit
and hospital closures resulting in loss of obstetric
services in rural U.S. counties from 2004 to 2014. This
is the first in a series of two policy briefs examining
the closure of hospital obstetric services in rural
areas; this policy brief takes a national perspective,
whereas a companion policy brief documents state-level
variability in access to hospital-based obstetric
services in rural counties from 2004-2014.
We found that between 2004 and 2014:
- The percent of all rural counties in the U.S. that
lacked hospital obstetric services increased from 45% to
54%, due to hospital and obstetric-unit closures.
- 179 rural counties (9% of all rural counties) lost
access to in-county hospital obstetric services.
- Women living in rural noncore counties (areas with
less than 10,000 residents) were disproportionately
affected by the loss of hospital obstetric services.
- Only 30.2% of rural noncore counties had continual
hospital obstetric services compared to 77.9% of