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Research Letter
July 14, 2020

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

Author Affiliations
  • 1University of Minnesota Rural Health Research Center, University of Minnesota School of Public Health, Minneapolis
JAMA. 2020;324(2):197-199. doi:10.1001/jama.2020.5662

In 2014, 54% of rural US counties had no hospital-based obstetric services, following a steady decline over the prior decade.1 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.2

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