A new report from consultancy Chartis found that 134 rural hospitals—or 12% of all rural hospitals that offered obstetric services—shut down their services between 2011 and 2018. Most of those service lines weren’t financially stable. The numbers don’t include 18 hospitals with OB departments that totally shut down.
At the time they stopped offering obstetric services, their median operating margins were negative 1.3%, and more than half of the hospitals with available data were operating in the red. But once they closed their maternity wards, only a “thin majority” of the hospitals became more stable, according to the report.
Now only 46% of all rural hospitals offer labor and delivery care, a stat that means about 3.8 million women in their childbearing years have to leave their county for maternal care, according to the Chartis report.
A similar trend is happening in cities, but the data are harder to come by. It was in evidence in the District of Columbia in 2017 when United Medical Center, the district’s only public hospital, closed its maternity ward.
In tandem, a nationwide OB-GYN shortage looms, driving further collaboration between the American College of Obstetricians and Gynecologists and the ACNM. The two groups have locked arms to push broader integration of nurse midwifery into the healthcare system.