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Nearly half of hospitals lack obstetric care. Plan maternity access now

A new University of Minnesota analysis shows that nearly half of U.S. hospitals had no obstetric services in 2024, and the pace of closures has not stopped.

3 min read
Nearly half of hospitals lack obstetric care. Plan maternity access now

Executive takeaway

Maternity access is now a regional planning problem. Map where your patients will deliver if a nearby unit closes, and settle transfer, staffing and prenatal care arrangements before the next closure forces them.

Article

What the new count shows

The University of Minnesota Rural Health Research Center released its first annual hospital-level review of obstetric service changes this month. Of 5,019 hospitals tracked, 718 lost obstetric care between 2010 and 2024, either because the unit shut or the whole hospital did. That is about 14% of the field.

Rural facilities carry a heavier share. They make up 39.3% of hospitals in the study but 43.9% of the losses, a loss rate of 16% compared with about 13% for urban hospitals. By 2024, 57.5% of rural hospitals and 43.6% of urban hospitals had no obstetric services. Nationally the share without them rose from 34.8% in 2010 to 49.1%.

The decline continues. Sixty-seven hospitals lost services in 2023 and 2024, while only six added them. Roughly 36,000 births in 2023 took place at hospitals that stopped offering obstetrics the following year.

Where the pressure is greatest

Long-term loss rates topped 20% in eight states plus the District of Columbia, led by New Hampshire, Iowa, Minnesota, South Carolina and Maine. Recent closures were concentrated in Indiana, Idaho, Alabama, Arkansas and Wisconsin. In 31 states, more than half of rural hospitals lacked obstetric services in 2024, compared with 12 states in 2010. Urban areas are not immune: 15 states now have more urban hospitals without obstetrics than with them.

The study counts closures but does not examine why they occurred or how far patients now travel. Leaders will need local data to answer those questions. A new HRSA-supported county repository, launched this week by the Rural Maternal Health Data Support program, lets users build county maternal health profiles covering demographics, provider capacity and outcomes, along with maps of obstetric availability.

Questions for the board

  • Who absorbs the volume? When a neighboring unit closes, emergency departments and remaining labor units see higher-risk, less-planned deliveries. Model staffing and transfer capacity before it happens.
  • Is our unit viable on its own? Low-volume programs should test regional partnerships, shared call coverage and telehealth links with a referral center before considering closure.
  • What happens before and after delivery? Hospitals that stop delivering can still keep prenatal and postpartum visits local, which protects outcomes and community trust.
  • Are we using the data? Pair the new county profiles with your own birth volumes and payer mix to frame decisions for state officials and funders.

Archive entry for Sep 11, 2026, added Nov. 11, 2026.

Sources

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