Dive Brief:

• Hospitals are increasingly shutting down their maternity wards, with nearly half of all U.S. hospitals lacking obstetric services as Medicaid cuts loom, according to a new report from the University of Minnesota Rural Health Research Center.
• Over 700 hospitals shuttered their maternity wards between 2010 and 2024, according to the report. Rural areas were hit the hardest, with more than 57% of rural hospitals lacking a birthing ward in 2024.
• Maternity ward closures are going to leave pregnant people in a lurch, according to the report, as hospitals brace for upcoming cuts to Medicaid.

Dive Insight:

Maternity wards are common targets for financially strained hospitals looking to cut costs, as they’re expensive to maintain and rely heavily on reimbursements from Medicaid, which providers say doesn’t cover the cost of care.

As such, rural and underserved hospitals have borne the brunt of maternity ward closures. Between 2023 and 2024, obstetrics closures were concentrated in the mostly rural states of Indiana, Alabama, Arkansas and Wisconsin, according to the report.

Overall, the number of rural states with half their obstetric wards shuttered rose from 12 to 31 during the study period. For urban states, the number of hospitals without maternity services increased from two to 15.

Maternity ward closures could leave pregnant people without anywhere to go. In 2024, nearly 36,000 births occurred in a hospital that ended up closing the following year. That shakes out to 1.4% of all rural births and 0.9% of all urban births in 2024, according to the report.

The closures could exacerbate existing maternal mortality rates in the U.S., which is home to the highest rate in the developed world at 22 maternal deaths per 100,000 live births, according to the Commonwealth Fund. The high maternal mortality rate is due in part to limited care access for birthing people.

Hospitals are also contending with upcoming Medicaid cuts, including new work requirements beginning in January. The cuts, enacted under the GOP’s “One Big Beautiful Bill” last year are expected to cause millions to lose insurance.

This will include pregnant people or women of reproductive age, which could further exacerbate maternity wards.

As it stands, Medicaid finances about 41% of all births in the U.S., according to the most recent federal data. But with the expected coverage losses, hospitals will no longer be able to rely on even Medicaid reimbursements, and some might incur greater uncompensated care costs.

The strain could push more hospitals to cut high-cost services, like obstetrics care, and affect states already grappling with maternity care deserts. Last month, March of Dimes found that maternity care deserts affect 2.4 million women nationwide.