124 Rural Hospital Maternity Services Closed, Closing in 6 Years: Analysis

From Becker’s Review

Since the end of 2020, 124 rural hospitals have closed their maternity units or shared plans to close them before 2026 is over, representing a 12% reduction in rural labor and delivery services, according to a new analysis from the Center for Healthcare Quality and Payment Reform.

Becker’s reported on 29 maternity service closures in 2025 and three so far in 2026.

The closures have happened at an average rate of more than two per month over the past four years, with only 41% of U.S. rural hospitals still providing labor and delivery services. In 12 states, fewer than one-third of rural hospitals provide maternity care.

The loss of local services has forced many pregnant women to travel 50 minutes or more to reach their nearest hospital with delivery capabilities. The analysis said women in communities without local maternity care face higher risks of complications and death during childbirth and are less likely to receive proper prenatal and postpartum care.

A primary driver of the closures is inadequate payments from both private insurance companies and Medicaid, according to the analysis. More than 100 rural hospitals that continue to deliver babies lost money overall in the last two years.

The report also highlighted workforce shortages, with rural hospitals struggling to recruit, train and retain obstetricians, family physicians, midwives and nurses trained in obstetric care who are willing to provide 24/7 on-call coverage.

Here are numbers on the 10 states that have seen the most maternity unit closures at rural hospitals, according to the report:

Note: The list includes travel times to the nearest hospital with delivery services and the count of rural hospitals without maternity care in 2025.

1. Indiana