More than 2 million women of reproductive age are living in rural counties that lack hospital obstetric care services, according to a study published in Health Affairs.
For the study, researchers identified 1,249 hospitals in 1,085 rural counties that offered obstetric services in 2004 based on data from the American Hospital Association Annual Survey. They also identified 898 rural counties that never had available hospital-based obstetric care between 2004 and 2014. Researchers used four other databases to determine various social and economic factors present in each county, including number of reproductive women, household income and racial and ethnic composition.
Here are five study findings.
1. Forty-five percent of rural counties did not have any hospitals with obstetric services between 2004 and 2014.
2. Nine percent of counties lost all hospital obstetric services in the county during the study period.
3. By 2014, 54 percent of rural communities lacked obstetric services. This figure equates to 2.4 million of reproductive age living in counties with no hospital obstetric services.
4. Counties with no access to obstetric services during the study period had higher percentages of non-Hispanic black women with lower median household incomes compared to rural counties with continual obstetric services.
5. The most isolated counties were more likely to have no obstetric services (58.6 percent) compared to micropolitan counties (17.6 percent).
"The increasing loss of hospital-based obstetric services in rural counties could exacerbate existing racial and income disparities in obstetric care, thereby increasing concerns about maternal and infant outcomes in vulnerable communities," the study authors concluded.
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