Across seven states, at least 25% of hospitals reported they no longer provided obstetric services by 2022, and more than a two-thirds of rural hospitals in eight states were without obstetric services, a recent study found.
The study, published in the July issue of Health Affairs, drew data from the American Hospital Association Annual Surveys and CMS to find the availability of hospital-based obstetric services across all U.S. states and the District of Columbia. The analysis included 4,964 short-term acute care hospitals, including OB-GYN specialty hospitals, open during 2010 and 2022. Researchers calculated the percentage of hospitals that lost obstetric services and those without obstetric services by state, and for rural and urban hospitals within states.
Researchers found that hospitals offering obstetric services have declined in nearly every state since 2010. The closures were a result of police and resource decisions, despite efforts from professional associations, health systems and community organizations to address obstetric care needs.
Three states had the highest percentage of rural hospitals without obstetrics — Florida at 87%, North Dakota at 81.1% and West Virginia at 70.4% —- and two states had the highest percentage of urban hospitals without obstetrics — South Dakota at 72.7% and Hawaii at 62.5%.
Here are states with the most obstetric service losses.
States where more than 25% of all hospitals lost obstetric services:
Iowa: 33.3%
West Virginia: 30%
District of Columbia: 28.6%
Rhode Island: 28.6%
Pennsylvania: 27.7%
South Carolina: 26.9%
Oklahoma: 26.2%
States with highest percentage of lost obstetric services lost in rural counties:
Pennsylvania: 46.2%
South Carolina: 46.2%
West Virginia: 42.9%
Florida: 40%
Iowa: 39.7%
District of Columbia: 28.6%
States with highest percentage of lost obstetric services lost in urban counties:
District of Columbia: 28.6%
Kansas: 30.4%
Rhode Island: 28.6%
Oklahoma: 27.6%
Hawaii: 25%
The states with the largest rural-urban differences in the percentage of hospitals that lost obstetric services:
New Hampshire: 36.4% (rural), 0% (urban)
Florida: 40.0% (rural), 11.8% (urban)
South Carolina: 46.2% (rural), 20.5% (urban)
Pennsylvania: 46.2% (rural), 22.1% (urban)
