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
Kozhimannil KB, Interrante JD, Tuttle MKS, Henning-Smith C. Changes in Hospital-Based Obstetric Services in Rural US Counties, 2014-2018. JAMA. 2020;324(2):197–199. doi:10.1001/jama.2020.5662
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