Loss of Hospital-Based Obstetric Services in Rural Counties in the United States, 2010-2022


Access to maternity care in rural United States (U.S.) counties has been on the decline in recent years. The purpose of this infographic is to show the loss of hospital-based obstetric services in rural counties from 2010 to 2022, and how this differs by rural county type (micropolitan vs. noncore).

Key Findings:

  • In the U.S., access to maternity care in rural counties continues to decline. Overall, 49.0% of rural counties (969/1976) had hospital-based obstetrics in 2010, and 41.2% of rural counties (814/1976) had hospital-based obstetrics in 2022. By 2022, 58.8% (1162/1976) of rural counties had no hospital-based obstetric services.
  • Among rural counties, we distinguished micropolitan and noncore rural counties. In 2010, 80.7% of micropolitan counties (517/641) had hospital-based obstetric care, declining to 73.9% (474/641) in 2022. Among noncore counties, the percentage with hospital-based obstetric services declined from 33.9% (452/1335) in 2010 to 25.5% (340/1335) in 2022.
  • While rare, 3 (0.5%) of micropolitan and 13 (1.0%) of rural noncore counties gained hospital-based obstetric services.
  • Rural noncore counties continue to be much less likely to have – and more likely to lose – hospital-based obstetric services than rural micropolitan counties. In rural noncore counties, there was an overall 9.4% (125/1335) decline in availability of hospital-based obstetric services vs. a 7.2% (46/641) decline in rural micropolitan areas. However, among counties that had hospital-based obstetric services in 2010, there was a 27.7% (125/452) decline in availability in rural noncore counties vs. a 8.9% (46/517) decline in rural micropolitan areas.
University of Minnesota Rural Health Research Center
Katy Kozhimannil, Julia Interrante, Alyssa Fritz, Emily Sheffield