Safe places to give birth are vanishing in rural America

Pregnant moms are losing safe places to give birth—and rural families are paying the price

Credit: Canva / Motherly

Because in parts of rural America, it’s not just hard to find a place to give birth. It’s becoming nearly impossible.

By Elizabeth Tenety Updated Aug. 08, 2025

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At a hospital in Kansas City, a group of labor and delivery nurses are exchanging job leads in a group chat, unsure whether to feel grateful or devastated. Their unit—once a lifeline for emergency births and complicated pregnancies across the region—is shutting down.

They’re changing jobs with the heavy knowledge of what their absence will mean.

Because in parts of rural America, it’s not just hard to find a place to give birth. It’s becoming nearly impossible.

“We’re just grieving for the community”

In September, Research Medical Center in Kansas City will close its maternity ward and NICU. The ripple effects will reach far beyond the city limits. The hospital has long been the fallback for rural hospitals that can’t handle high-risk deliveries—hypertension, hemorrhage, breech births. Now, those emergencies may require helicopter transfers or hours-long drives.

“We know they’re going to have a lot of issues after we’re gone,” said Jessica Wheat, a labor and delivery nurse who’s moving on but not moving past it.

She’s not alone in her concern. In many towns across the country, the closest maternity care is now hours away. For some expecting moms, that means skipping prenatal appointments. For others, it means giving birth in transit. For too many, it will mean worse outcomes.

This isn’t a fluke. It’s a trend.

Between 2010 and 2022, over 500 U.S. hospitals closed their obstetrics units. Today, more than half of rural counties lack hospital-based labor and delivery care, and about 1 in 3 counties have no OBGYN at all, according to data compiled by the March of Dimes.

What used to be described as “maternity care deserts” are quickly becoming barren wastelands.

The new wave of closures is being triggered by a political choice: sweeping federal Medicaid cuts signed earlier this year that disproportionately threaten rural hospitals. Since Medicaid covers about 40% of all U.S. births, even modest funding reductions leave financially strapped hospitals with few options—and labor and delivery units are often the first to go.

One analysis by the National Partnership for Women & Families estimates that nearly 150 rural maternity units are now at risk of closing or downsizing.

The disappearing village

If you’re picturing glossy birthing centers in major cities, you’re missing the bigger picture. In many rural areas, a local OB-GYN or maternity unit was never just for delivery—it was often the only place women received birth control counseling, cancer screenings, or a check-in on their mental health.

When those services vanish, so does the last thread of a community-based care network. And for many pregnant people on Medicaid—especially Black, Indigenous, and Latine moms in underserved counties—that loss can’t be replaced with an app or a hotline.

So what now?

Here’s what expecting moms in rural areas need to know—and do—if their local hospital closes its doors:

Start early: Ask your current provider if and where they’ll continue offering prenatal care. If you’re low-risk, see if virtual check-ins are possible.
Explore birth centers and midwifery options: Certified nurse-midwives and doulas are increasingly filling care gaps, especially in rural and Southern states.
Check for state Medicaid transportation support: Many states offer mileage reimbursement or rides to doctor’s appointments—but it’s rarely well advertised.
Know your rights: Even in states with abortion bans, you are still entitled to emergency maternal care, including medically necessary C-sections and labor support.

And if your hospital is closing? You’re not alone—and this isn’t your fault. Your safety and your baby’s future should never depend on a ZIP code or a policy fight in Washington.

One more thing…

To the nurses packing up bassinets and delivering final babies before the doors shut—we see you. You’re not “just” leaving a job. You’re closing a chapter in your community’s story, one where care, dignity, and safe birth were still possible—at least for a while.

And to the moms who’ll be driving two hours to their next ultrasound: You deserve better. But until this system catches up? We’ll keep sharing your stories—and fighting to make sure they’re heard.

📍 If this is happening in your area, you can contact the National Rural Health Association or check Every Mother Counts for advocacy and support.

🔗 Read The 19th’s original reporting for more details on Medicaid cuts and hospital closures.

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