Enhancing Rural Maternity Care: The Role of Family Physicians and Support for High-Need States

A recent study published in The Annals of Family Medicine sheds light on the significant impact family physicians have on maternity care in rural regions across the United States. By analyzing county-level data and healthcare resources, researchers found that family physicians frequently serve as the primary source of maternity care in underserved rural counties. The study categorized counties into three types: those where family physicians are the sole providers with hospitals offering obstetric services, those where family physicians are the only providers without hospital-based obstetric care, and counties where only hospitals provide maternity services without physician involvement.

The findings reveal that most vulnerable counties providing maternal care are primarily rural and concentrated in the central U.S., including states like Texas, Iowa, Nebraska, and Kansas. Counties solely reliant on hospitals for obstetric services tend to have higher social deprivation and larger Black populations, especially in Mississippi, Missouri, Oklahoma, and Texas. Conversely, counties served by family physicians—whether in collaboration with hospitals or independently—exhibit better maternal outcomes, including lower rates of preterm births, low birth weight, and infant mortality.

Despite these positive contributions, there are substantial gaps in maternity care access, especially in high-need states. The study highlights the importance of expanding training programs focused on obstetrics, such as rural training tracks, obstetric fellowships, and family medicine residency programs with a focus on maternity care. Strengthening these avenues can help address the geographic disparities and improve maternal and neonatal health outcomes in underserved areas.

Overall, supporting family physicians in rural areas and investing in specialized training are vital strategies to expand access to quality maternity care and reduce disparities, particularly in high-need regions where healthcare resources are limited.