Rural US hospitals experiencing labor, delivery crisis

Editor's Note:

Rural communities are at serious risk due to hospitals’ increasing inability to offer labor and delivery services, according to a new report from the Center for Healthcare Quality & Payment Reform. Highlights include:

• More than half (55%) of rural hospitals in the U.S. do not offer labor and delivery services, and in 10 states, more than two-thirds do not offer these services, including Nevada, North Dakota, Louisiana, Oklahoma, Alabama, Mississippi, Florida, Illinois, Virginia, and West Virginia.
• As 300 rural hospitals have stopped labor and delivery services over the past decade, more than 70% of rural residents have been forced to travel 30 minutes or more to reach the nearest hospital that can offer obstetrical care.
• The crisis is growing: financial pressures in rural hospitals means hundreds of additional communities are at risk of losing maternity care, which requires having physicians and nurses available 24/7.  
• Authors recommend immediate action to address workforce issues, including recruitment and training for rural maternity care; remote specialty support for rural maternity care teams; and new staffing models for on-site coverage. 
• They also note that insurance coverage needs to change, as payments per birth at a larger hospital will not support maternity care staffing costs at a rural hospital.