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Rural Counties Lose Birthing Units

May 4, 2017

Photo of an infant's legs and feet.Amid a series of recent findings by the Centers for Disease Control and Prevention and others about the health of rural America, a new study by the University of Minnesota has found that the availability of obstetric services has declined in the past decade. 

Between 2004 and 2014, the percentage of rural counties that lacked hospital obstetrics (OB) units increased from 45 to 54 percent, according to the university’s Rural Health Research Center, one of 10 such centers funded by HRSA nationwide.

Financial pressure, insurance problems and doctor shortages forced more than 200 hospitals to close their birthing units, leaving 9 percent of U.S. rural residents with no in-county services. In all, the study found, 179 counties are affected.

The finding comes at a time when nearly 80 small, rural hospitals HRSA Exit Disclaimer have closed their doors completely due to similar constraints.

“Having access to OB services in rural communities is crucial for women and children, and this study demonstrates the need to continue to identify alternative health care models that can be used to provide these services,” said Tom Morris, Associate Administrator of the Federal Office of Rural Health Policy. Over 28 million reproductive-aged women live in rural U.S. counties.

Researchers found that the obstetrics closures disproportionately affect rural counties. That finding comes from one of two new policy briefs released by the center in April that focus on the national perspective HRSA Exit Disclaimer (PDF - 553 KB) and an examination of state-level variability HRSA Exit Disclaimer (PDF - 759 KB) in access to hospital-based OB services.

The loss of services is most severe for women living in counties with less than 10,000 residents. Only 40 percent of those counties had continual hospital OB services, compared to 78 percent of more populous counties.

The second policy brief examines state variations, and the scope of loss of services from 2004 to 2014. Florida, Nevada, and South Dakota fared worst -- with more than two-thirds of their rural counties having no in-county hospital OB services.

Date Last Reviewed:  May 2017

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