Changes in Hospital-Based Obstetric Services in Rural US Counties, 2014-2018

Publication Date: July 15th, 2020
Publication Type(s): Peer-reviewed Journal Publications
Topic(s): , , , ,
Author(s): Kozhimannil KB, Interrante JD, Tuttle MS, Henning-Smith C

Abstract: In 2014, 54% of rural US counties had no hospital-based obstetric services, following a steady decline over the prior decade. Loss of rural maternity care is associated with adverse maternal and infant health outcomes. Rural counties that have lost hospital-based obstetric services experienced higher rates of emergency department births, and in rural counties not adjacent to urban areas, increases in preterm birth, a leading cause of infant mortality. Risks of infant and maternal mortality are elevated for rural residents, highlighting the importance of clinical and policy efforts to ensure rural obstetric care access. The purpose of this study was to describe hospital-based obstetric service losses in rural US counties from 2014 to 2018.

Published in: JAMA

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