Obstetric Care Is Becoming Scarcer in the Rural U.S.

Loss of rural maternity care is associated with adverse maternal and infant health consequences, including more emergency department deliveries and more preterm births. Rural U.S. counties have seen a steady decline in hospital-based obstetric care, with 54% reporting no such services in 2014. Has this decrease persisted? For the study period from 2014 to 2018, hospitals were classified as providing obstetric services each year if they reported either meeting all American Hospital Association parameters (provision of obstetric care, at least level 1 maternity care status, ≥1 dedicated obstetric bed, ≥10 births annually) or at least one parameter plus having obstetric services in the Medicare & Medicaid Services' Provider of Services File. D…