That is based on an article in JAMA primarily based on a report from the Center for Healthcare Quality and Payment Reform. The report states:
More than half (55%) of the agricultural hospitals within the U.S. don’t provide labor and supply providers, and in 10 states, greater than two-thirds don’t. Over the previous decade, greater than 200 rural hospitals throughout the nation have stopped delivering infants…
In most city areas, the journey time to a hospital with labor and supply providers is below 20 minutes, however in rural areas, the journey time is prone to be at the least half-hour, and it’s typically 40 minutes or extra.
https://ruralhospitals.chqpr.org/downloads/Rural_Maternity_Care_Crisis.pdf
The longer journey distances impression not solely entry to care throughout supply, but in addition prenatal and post-natal care.
The absence of native maternity care providers is felt all through the continuum of obstetric care. Patients are much less prone to acquire satisfactory prenatal or postpartum care providers if they should journey lengthy distances.
“It’s one thing to say the mother has to drive half an hour to deliver her baby,” Miller stated. “It’s another thing to say the mother has to drive a half an hour every month to be able to get prenatal care. They can’t take time off of work, can’t take time away from the kids.”
https://jamanetwork.com/journals/jama/fullarticle/2815499
Why are rural hospitals dropping maternity care? Clearly the reply is that reimbursement is much beneath their price. Moreover, discovering satisfactory staffing is tough.
Maintaining labor and supply providers requires having physicians and nurses, together with nurse anesthetists or anesthesiologists, who’re skilled and out there across the clock to handle deliveries as wanted. As a consequence, funds per delivery which can be satisfactory at a big hospital usually are not sufficient to assist maternity care at small rural hospitals with far fewer births.
“We deliver about 300 babies a year, so an average of less than 1 a day, but you still have to have OB-GYN coverage 365 days a year, 24 hours a day, 7 days a week because babies come at all times,” Sinek stated in an interview. “It’s costing us $7.5 million right now to staff our OB unit with nurses that know what they’re doing and CRNAs [certified registered nurse anesthetists] to do anesthesia services and the office staff to support that care. All of that is really adding up, and if you don’t deliver enough babies to cover those costs, then you’re on a downhill course.”…fewer obstetricians and household physicians with obstetric abilities are in a position or prepared to be on name a number of nights and weekends out of each month…As a consequence, hospitals both should make use of or contract with extra physicians or OB-GYN hospitalists.
https://jamanetwork.com/journals/jama/fullarticle/2815499
You can learn the total report right here.