At a Kansas City hospital, labor and delivery nurses are sharing job opportunities in a group chat, caught between feelings of gratitude and sorrow. Their unit, once a critical resource for emergency births and complex pregnancies in the region, is set to close.
They’re transitioning to new jobs while acutely aware of the impact their departure will have.
In various rural parts of America, finding a place for childbirth is not just difficult; it’s increasingly becoming unfeasible.
“We’re just grieving for the community”
Research Medical Center in Kansas City plans to shut down its maternity ward and NICU this September. The repercussions will extend well beyond the city. For years, this hospital has served as a backup for rural facilities unable to manage high-risk deliveries—such as hypertension, hemorrhage, and breech presentations. Now, those urgent cases could necessitate helicopter transfers or extended car rides.
“We know they’re going to have a lot of issues after we’re gone,” noted Jessica Wheat, a labor and delivery nurse who is moving on but hasn’t left the situation behind.
Her anxieties are shared by many. In numerous towns across the U.S., the nearest maternity care is now hours away. For some pregnant women, this means they may miss prenatal appointments; for others, it translates to giving birth while traveling. Unfortunately, for many, this could result in poorer health outcomes.
These closures are not mere anomalies; they indicate a broader pattern.
From 2010 to 2022, over 500 obstetrics units in U.S. hospitals have shuttered. Currently, more than half of rural counties lack hospital-based labor and delivery services, and about a third of counties have no OBGYNs at all, according to findings from the March of Dimes.
What were once termed “maternity care deserts” are rapidly transforming into desolate regions.
The latest surge in closures is fueled by a political decision: sweeping federal Medicaid cuts enacted earlier this year, which pose a grave threat to rural hospitals. Given that Medicaid accounts for approximately 40% of all births in the U.S., even slight funding reductions leave struggling hospitals with limited choices—and labor and delivery units are often among the first to go.
According to an analysis by the National Partnership for Women & Families, nearly 150 rural maternity units are currently at risk of closure or downsizing.
The vanishing community
If you envision fancy birthing centers in bustling cities, you might be overlooking the larger context. In many rural settings, a local OB-GYN or maternity unit was not just for childbirth; it often served as the sole provider of birth control guidance, cancer screenings, or mental health check-ins.
The disappearance of these services extinguishes a vital thread in the community-based care network. And for many pregnant people on Medicaid—especially Black, Indigenous, and Latine moms in neglected counties—this gap cannot be bridged by an app or a hotline.
So what can be done?
Here’s what expecting mothers in rural regions need to consider—and actions to take—if their local hospital closes:
- Start early: Consult your current provider about where they will continue to offer prenatal care. If you’re low-risk, explore the possibility of virtual check-ins.
- Investigate birth centers and midwifery options: Certified nurse-midwives and doulas are increasingly stepping in to cover care needs, particularly in rural and Southern states.
- Look for state Medicaid transportation support: Many states provide transportation reimbursement or rides to medical appointments—but this information isn’t always well publicized.
- Know your rights: Even in states with abortion restrictions, you have the right to emergency maternal care, including medically necessary C-sections and labor support.
If your hospital is closing, remember: you’re not alone, and this situation is not your fault. Your safety and your baby’s future shouldn’t depend on your ZIP code or a political dispute in Washington.
One last message…
To the nurses who are packing up bassinets and handling final deliveries before the doors close—we recognize your contributions. You’re not merely leaving a job; you’re closing a chapter in your community’s narrative, one where care, dignity, and safe childbirth were once possible—if only for a moment.
And to those mothers who will be traveling two hours for their next ultrasound: You deserve better. Until the system improves, we will continue to amplify your stories and advocate for attention to your needs.
Image Source: Unsplash
