49% of US hospitals lack obstetric services

Nearly half of all US hospitals no longer have obstetric services.

From 2010 to 2024, 718 US hospitals lost labor and delivery services, according to a recent overview from the University of Minnesota’s Rural Health Research Center. In that time frame, the percentage of hospitals without obstetric units increased from 34.8% to 49.1%, the researchers found.

Those numbers may get worse in the face of Medicaid cuts included in last year’s One Big Beautiful Bill. Medicaid paid for 41% of births in 2023, according to data from health policy research firm KFF. There are about 3.6 million births in the US annually. Because of this, “large cuts to Medicaid will put significant strain on maternity care,” Adam Searing, an associate professor of the practice at Georgetown University, wrote in a blog post.

Uneven impact. A related study from the University of Minnesota, published Sept. 11 in JAMA Health Forum, found that low birth volume, unprofitability, for-profit status, and distance to another hospital with obstetric services were all factors that contributed to obstetric care losses between 2010 and 2023.

Of 1,126 rural hospitals with obstetric units in 2010, 239 lost their obstetric unit and 42 hospitals shut down entirely by 2023. Out of 1,982 urban hospitals, 250 lost their obstetric unit and 92 hospitals closed, the study found.

According to the university’s 2026 annual overview on changes in hospital-based obstetric service availability, the closures disproportionately affected rural areas, where 58% of hospitals (1,133) don’t have obstetric services, compared to 44% of urban hospitals (1,330). With fewer options, rural patients may have to make long trips to get maternal care, which can lead to an increase in riskier births taking place outside a hospital setting. As of 2024, 35% of US counties were considered maternity care deserts.

Of the hospitals in the study that still had obstetric services in 2023, 41% had signs indicating they may shut down their obstetric services in the future.

Some states have said they will use the money they receive from the $50 billion Rural Health Transformation Program (RHTP) to improve maternal health services.

Paula Chatterjee, an assistant professor of medicine at the University of Pennsylvania’s medical school, previously told Healthcare Brew that she’s seen “a lot of novel approaches to think about maternal health care delivery to remote settings.”

New Mexico, for instance, which has large maternal health deserts, received $211 million in RHTP funds and has selected six sites around the state that will work to bring maternity and other care closer to people living in rural areas.

Julia Interrante, research fellow, statistical lead for the Rural Health Research Center, and lead author of the study, said in a statement that the study’s findings “can help policymakers identify where action may be needed to preserve access to care.”

“Policies that address the financial pressures of providing obstetric care, particularly at hospitals with lower birth volumes, along with approaches that help hospitals share resources and sustain essential services, could help prevent further losses,” she added.