As rural hospital and obstetric unit closures continue to affect rural communities across the US, little is known about the consequences of these closures in terms of access to maternity care and outcomes of childbirth for women and infants. Data to inform policy efforts are needed, as no current research documents the county-level effects of the loss of obstetric services on maternity care, location of childbirth, or birth outcomes. Further, little is known about the strategies rural women use to obtain maternity care in the wake of a closure and the effects of a closure on clinicians and communities. This project will examine the relationship between closure of an obstetric unit or hospital and maternity care and outcomes of childbirth in rural US counties including prenatal care, distance to delivery hospital, out-of-hospital birth, and infant health outcomes
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