Decline in Hospital-Based Obstetric Care in the US, Major Impact on Rural Areas

Access to comprehensive obstetric care through hospitals is essential for promoting maternal and infant health outcomes. However, recent research led by the University of Minnesota School of Public Health indicates a significant decline in hospital-provided obstetric services across the United States over the past decade. The study analyzed data from nearly 5,000 short-term, acute-care hospitals nationwide between 2010 and 2022, revealing a troubling pattern of widespread closures and service reductions, especially in rural communities.

Using a refined algorithm to identify hospitals that ceased offering obstetric care—either by complete closure or by shutting down obstetric units—the researchers distinguished between urban and rural locations. The findings showed that rural hospitals have been disproportionately affected, with some states experiencing severe reductions. For example, in North Dakota, 73% of hospitals lacked obstetric services by 2022, while Oklahoma and West Virginia also faced closures impacting over 60% of their rural hospitals.

Furthermore, the study highlighted significant variability among states. While states like Delaware, Utah, and Vermont maintained stable obstetric services, others such as Iowa, West Virginia, and Oklahoma saw over 25% of their hospitals eliminate these services. The loss of obstetric care is not only a matter of hospital closures but also the shutdown of obstetric units within hospitals that remain open.

Katy Backes Kozhimannil, a lead author, emphasized that the decline in hospital-based obstetric care poses risks to pregnant individuals and newborns, especially in rural and highly rural areas. Reduced access can lead to increased travel distances to nearest facilities, thereby elevating the risk of adverse health outcomes.

This trend occurs amidst a broader maternal health crisis in the US, underscoring the urgent need for policy measures to improve healthcare infrastructure and access. The study results suggest that rural populations are particularly vulnerable, necessitating targeted interventions to prevent further erosion of obstetric services.

The research was conducted collaboratively with experts from the University of Pennsylvania and Harvard University, published in alth Affairs. It underscores a critical public health challenge that demands immediate attention to safeguard maternal and infant health across all communities.

Source: https://medicalxpress.com/news/2025-07-hospital-based-obstetric-declines-rural.html