Abstract

In 2022, more than half of rural hospitals and one-third of urban hospitals in the United States lacked obstetric services, reflecting an escalating trend of hospital labor and delivery (L&D) unit closures across the US. Despite some large-scale studies reporting negligible impacts of L&D closures on maternal health, an analysis of the literature presents a clear net negative impact for vulnerable women, including those who identify as members of a racial or ethnic minority, those who have low-income, and those who are Medicaid members. For many families, the disappearance of local obstetric care is not merely an inconvenience but instead is a direct threat to health and safety, presenting as a reduction in access to care through pregnancy, an increase in travel-related risks, and potential life-threatening health outcomes.

Department

College of Health and Human Services Institute for Health Policy and Practice

Publication Date

Winter 12-1-2025

Grant/Award Number and Agency

Endowment for Health

Document Type

Article

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