County-Level Availability of Obstetric Care and Economic Implications of Hospital Closures on Obstetric Care


This policy brief provides descriptive data on the economic changes underway in counties that lost obstetric care facilities between 2012 and 2019.

Key Findings
  • The majority of rural counties in the United States do not have an obstetric care provider within their borders (micropolitan and non-core as defined by the National Center for Health Statistics urban-rural definitions).
  • Counties without obstetric care facilities have higher rates of poverty and lower rates of health insurance coverage across all ages.
  • For the years studied, data illustrate a decline in economic activity after counties experienced a loss in obstetric facilities, either through facility conversion or through hospital closure.
  • Counties which lost obstetric care access also had decreases in their labor forces and population of reproductive age.
Center for Economic Analysis of Rural Health
Andrew Owen, Alison Davis, Simona Balazs