Feb 5, 2024 - News

Access to obstetric care in rural North Carolina has dwindled

Share of rural hospitals without labor and delivery services
Data: Center for Healthcare Quality and Payment Reform; Note: Rural hospitals are those not located within a metropolitan area defined by the U.S. OMB and Census Bureau; Map: Axios Visuals

More than a third of North Carolina's rural hospitals don't offer maternity care, as challenging economics and labor shortages force more rural facilities to stop providing labor and delivery services.

The big picture: Hospitals have been increasingly scaling back or cutting maternity services for financial reasons — while demand for obstetrics care rises as more states ban abortion.

  • High-quality maternity care requires having 24/7 physician and nurse staffing, and that's expensive for rural hospitals to continue providing, as they are losing money on other types of patient care, the report explains.

It takes patients in rural parts of North Carolina a median of 32 minutes to get to a hospital that provides obstetric care, according to a new report from the Center for Healthcare Quality and Payment Reform.

  • Minutes matter in labor and delivery: Mothers and babies in communities without obstetric care have a higher risk of death and complications, and they're less likely to obtain adequate prenatal care and postpartum care, according to the report.

Zoom out: More than half of rural hospitals in the country (55%) don't have obstetric services, as more than 200 U.S. rural hospitals have stopped delivering babies in the past decade.


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