Rural Maternal Health – Resources
Selected recent or important resources focusing on Rural Maternal Health.
Severe Maternal Morbidity and Mortality After Delivery Hospitalization Among Rural Residents Bypassing Local Care for Urban Hospitals
Examines severe maternal morbidity and mortality (SMMM) when labor and delivery patients bypass rural, local hospitals to give birth at urban hospitals. Analyzes 235,375 rural versus urban births in South Carolina and associated 1-year postpartum follow-up visit data for rates of SMMM.
Author(s): Peiyin Hung, Haoyuan Gao, Jihong Liu, et al.
Citation: JAMA Network Open, 8(11), e2544522
Date: 11/2025
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Examines severe maternal morbidity and mortality (SMMM) when labor and delivery patients bypass rural, local hospitals to give birth at urban hospitals. Analyzes 235,375 rural versus urban births in South Carolina and associated 1-year postpartum follow-up visit data for rates of SMMM.
Author(s): Peiyin Hung, Haoyuan Gao, Jihong Liu, et al.
Citation: JAMA Network Open, 8(11), e2544522
Date: 11/2025
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Positive Outliers: How Some Rural Communities Maintain Access to Labor and Delivery Services
Explores healthcare providers' approaches to ensuring maternal care access in rural Texas, Oklahoma, Alabama, and Mississippi. Provides case studies on the role of rural hospitals and clinics in providing labor and delivery services, discusses financial and logistical challenges faced by providers, and details funding, policy, and service delivery strategies supporting continued access.
Author(s): Sarah Klein, Molly Castle Work
Date: 10/2025
Sponsoring organizations: Bassett Research Institute, Commonwealth Fund
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Explores healthcare providers' approaches to ensuring maternal care access in rural Texas, Oklahoma, Alabama, and Mississippi. Provides case studies on the role of rural hospitals and clinics in providing labor and delivery services, discusses financial and logistical challenges faced by providers, and details funding, policy, and service delivery strategies supporting continued access.
Author(s): Sarah Klein, Molly Castle Work
Date: 10/2025
Sponsoring organizations: Bassett Research Institute, Commonwealth Fund
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2010-2023 County-Level Hospital-Based Obstetric Care Status
County-level dataset containing the county Federal Information Processing Standard (FIPS) code, county, state, and indicator of whether each county had hospital-based obstetrics care in years 2010-2023. Available for download as an XLS file.
Author(s): Julia D. Interrante, Emily C. Sheffield, Kevan O'Hanlon, Katy Kozhimannil
Date: 10/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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County-level dataset containing the county Federal Information Processing Standard (FIPS) code, county, state, and indicator of whether each county had hospital-based obstetrics care in years 2010-2023. Available for download as an XLS file.
Author(s): Julia D. Interrante, Emily C. Sheffield, Kevan O'Hanlon, Katy Kozhimannil
Date: 10/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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An Enhanced Method for Identifying Hospital-Based Obstetric Unit Status, Version 2 with Addendum
Results of a study using data from American Hospital Association annual surveys from 2010-2018 to conduct single- and multi-year assessments of obstetric unit status and to identify closures of obstetric units. Compares results obtained through the enhanced method with results of a survey sample of rural hospitals with obstetric units open at the time of the assessment and those with recently closed units. Addendum describes methodology updates since a previously published January 2022 report as well as additional findings using 2010-2023 data.
Additional links: An Enhanced Method for Identifying Hospital-Based Obstetric Unit Status (Version 1, 2022)
Author(s): Julia D. Interrante, Caitlin Carroll, Emily C. Sheffield, et al.
Date: 10/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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Results of a study using data from American Hospital Association annual surveys from 2010-2018 to conduct single- and multi-year assessments of obstetric unit status and to identify closures of obstetric units. Compares results obtained through the enhanced method with results of a survey sample of rural hospitals with obstetric units open at the time of the assessment and those with recently closed units. Addendum describes methodology updates since a previously published January 2022 report as well as additional findings using 2010-2023 data.
Additional links: An Enhanced Method for Identifying Hospital-Based Obstetric Unit Status (Version 1, 2022)
Author(s): Julia D. Interrante, Caitlin Carroll, Emily C. Sheffield, et al.
Date: 10/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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Financial Challenges of Providing Obstetric Services at Rural US Hospitals
Presents a study on the financial challenges faced by rural hospitals operating obstetric units. Bases findings on survey data from hospital administrators detailing financial factors such as payer mix, fixed costs, and workforce, among other measures.
Author(s): C.E. Busse, K. O'Hanlon, K.B. Kozhimannil, J.D. Interrante
Citation: Journal of Rural Health, 41(4), e70082
Date: 10/2025
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Presents a study on the financial challenges faced by rural hospitals operating obstetric units. Bases findings on survey data from hospital administrators detailing financial factors such as payer mix, fixed costs, and workforce, among other measures.
Author(s): C.E. Busse, K. O'Hanlon, K.B. Kozhimannil, J.D. Interrante
Citation: Journal of Rural Health, 41(4), e70082
Date: 10/2025
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Rural-Urban Differences in Dietary Intake Across Pregnancy Trimesters: A Multisite Prospective Cohort Study
Examines the relationship among dietary intake during pregnancy, socioeconomic status (SES), and rural versus urban location. Analyzes screening data from 495 pregnant women with rural versus urban breakdowns according to study site; demographics; SES variables of income, education, and insurance status; and fiber intake. Discusses the impact of rurality and SES on nutrition during pregnancy.
Author(s): Alex H. Crisp, Bethany Barone Gibbs, Jacob B. Gallagher, et al.
Citation: Journal of Rural Health, 41(4), e70085
Date: 10/2025
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Examines the relationship among dietary intake during pregnancy, socioeconomic status (SES), and rural versus urban location. Analyzes screening data from 495 pregnant women with rural versus urban breakdowns according to study site; demographics; SES variables of income, education, and insurance status; and fiber intake. Discusses the impact of rurality and SES on nutrition during pregnancy.
Author(s): Alex H. Crisp, Bethany Barone Gibbs, Jacob B. Gallagher, et al.
Citation: Journal of Rural Health, 41(4), e70085
Date: 10/2025
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Boosting Maternity Care in Rural America
Provides a brief overview of the state of maternal healthcare in rural areas. Highlights state and federal actions taken to improve access to quality maternal care and improve birth outcomes.
Date: 09/2025
Sponsoring organization: National Conference of State Legislatures
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Provides a brief overview of the state of maternal healthcare in rural areas. Highlights state and federal actions taken to improve access to quality maternal care and improve birth outcomes.
Date: 09/2025
Sponsoring organization: National Conference of State Legislatures
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Rural Resource: Availability of Obstetric Simulation Training by State
Explores the availability of simulation training and continuing medical education (CME)/distance learning opportunities for both rural hospitals with obstetric units and those without obstetric units. Presents findings of an environmental scan of national, regional, and state-level obstetric training resources. Offers recommendations for ways State Flex Programs and Critical Access Hospitals can use this resource to identify applicable simulation trainings.
Author(s): Madeleine Pick, Hamdi Abas, Megan Lahr
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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Explores the availability of simulation training and continuing medical education (CME)/distance learning opportunities for both rural hospitals with obstetric units and those without obstetric units. Presents findings of an environmental scan of national, regional, and state-level obstetric training resources. Offers recommendations for ways State Flex Programs and Critical Access Hospitals can use this resource to identify applicable simulation trainings.
Author(s): Madeleine Pick, Hamdi Abas, Megan Lahr
Date: 09/2025
Sponsoring organization: Flex Monitoring Team
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Pregnancy-Care Intentions and Practice among Family Medicine Physicians: Residents, Obstetric Fellows, and Fellowship Alumni
Examines the intentions of family medicine residents, family medicine obstetrics (FMOB) fellows, and FMOB alumni related to providing pregnancy care in rural areas. Utilizes survey data from 76 respondents and provides data breakdowns on their demographics, practice characteristics, and type of pregnancy care. Discusses issues of pregnancy care access in rural areas and the associated role of FMOB professionals.
Author(s): Robert William Owens, Mimi Dahlin, Emmanuel Adediran, et al.
Citation: Family Practice, 42(5)
Date: 09/2025
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Examines the intentions of family medicine residents, family medicine obstetrics (FMOB) fellows, and FMOB alumni related to providing pregnancy care in rural areas. Utilizes survey data from 76 respondents and provides data breakdowns on their demographics, practice characteristics, and type of pregnancy care. Discusses issues of pregnancy care access in rural areas and the associated role of FMOB professionals.
Author(s): Robert William Owens, Mimi Dahlin, Emmanuel Adediran, et al.
Citation: Family Practice, 42(5)
Date: 09/2025
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Rural/Urban Differences in Health, Health Care Use, and Barriers to Care for Postpartum and Parenting Women, 2006-2018
Presents a study on rural and urban differences in access to and utilization of healthcare for postpartum or parenting women. Highlights barriers women parents face in accessing care and utilizing care that is available. Breaks down data by age of child, barriers to care, rural versus urban location, and compares rates for postpartum and parenting women to all women aged 18-49 by rurality.
Author(s): Julia D. Interrante, Clara E. Busse, Alyssa Fritz, et al.
Date: 08/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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Presents a study on rural and urban differences in access to and utilization of healthcare for postpartum or parenting women. Highlights barriers women parents face in accessing care and utilizing care that is available. Breaks down data by age of child, barriers to care, rural versus urban location, and compares rates for postpartum and parenting women to all women aged 18-49 by rurality.
Author(s): Julia D. Interrante, Clara E. Busse, Alyssa Fritz, et al.
Date: 08/2025
Sponsoring organization: University of Minnesota Rural Health Research Center
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Last Updated: 11/20/2025