Peiyin Hung

TL;DR: Using national data, it is found that 9 percent of rural counties experienced the loss of all hospital obstetric services in the period 2004-14, which left more than half of all rural US counties without hospital Obstetric services.

TL;DR: In rural US counties not adjacent to urban areas, loss of hospital-based obstetric services, compared with counties with continual services, was associated with increases in out-of-hospital and preterm births and births in hospitals without obstetric units in the following year; the latter also occurred in urban-adjacent counties.

TL;DR: Rural obstetric unit closures are more common in smaller hospitals and communities with a limited obstetric workforce, and concerns about continuity of rural maternity care arise for women with local prenatal care but distant intrapartum care.

TL;DR: The ACA dependent coverage provision was associated with a reduction in preterm births, increase in use of prenatal care, and increase in births paid for through private insurance, which affected unmarried women more than married women.

TL;DR: The types and combinations of clinicians who are delivering babies in rural hospitals, their employment status, the relationship between hospital birth volume and staffing models, and the staffing challenges faced by rural hospitals are described.