A federal program that funded three rural maternal health networks in Minnesota, Missouri and West Virginia improved prenatal and postpartum care access for more than 8,600 women, according to a 2026 report.
HRSA’s “Rural Maternity and Obstetrics Management Strategies Program,” details the second cohort of RMOMS networks and was flagged by the American Hospital Association July 24.
In 2024, HHS committed $15 million over four years to address rural maternal health needs, roughly half of it through RMOMS.
Six things to know from the new report:
1. The networks operated from September 2021 through August 2025.
HRSA’s Federal Office of Rural Health Policy funded three awardees for one planning year and three implementation years:
- Families First, led by Sioux Falls, S.D.-based Sanford Health, across six northern Minnesota counties
- RMOM-Southeast Missouri Partnership, led by FQHC Missouri Highlands Health Care, across seven southeastern Missouri counties
- West Virginia Rural Maternity and Obstetrics Management Strategies Collaborative, led by the West Virginia Perinatal Partnership, across eight central West Virginia counties
2. The networks served 8,613 women and 7,336 infants.
The 2021 networks served 8,613 women, of whom 7,245 delivered 7,336 infants. Across both RMOMS cohorts since 2019, the program has reached more than 15,600 women.
The populations were small and spread across large geographic areas, reflecting the networks’ role in very rural service areas. Medicaid covered 61% of 2021 cohort participants, above the 47% rate for rural areas nationally.
3. First-trimester prenatal care and postpartum visits both rose.
The share of women receiving a first-trimester prenatal visit climbed from 72% in the first implementation year to 77% in the second — above the 75% rural national average — before easing to 74% in the third year.
Postpartum visit utilization increased each year, from 61% to 67%. The report said the findings should be read with caution, given the small rural populations.
4. Infant outcomes held at or below rural benchmarks.
Preterm births across the cohort fell from 10% to 9%, and low birthweight from 8% to 7% — both under the rural national averages of 13% and 9%. The Missouri cohort recorded the largest drop in preterm births, from 14% in the first year to 11% in the second.
5. The networks leaned on telehealth, navigation and transportation to close access gaps.
Strategies included maternal-fetal medicine telehealth, remote monitoring of blood pressure and glucose, patient navigation, and simulation training on obstetric mannequins for low-volume delivery hospitals.
In Minnesota, Families First adapted a group prenatal care model for two Indian Health Service sites, where 80% of eligible patients opted in, and ran a dedicated van that averaged 44 rides per month in summer 2025. The West Virginia network placed a doula who had attended 19 births by March 2025 at what became the first hospital in the state with a doula-specific written policy.
6. Networks expect most initiatives to outlast the funding.
Awardees said they anticipate sustaining most efforts through insurance reimbursement or partner commitment. The results land as rural hospitals continue to close obstetric units, forcing pregnant patients to travel long distances for routine and high-risk care.
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