That’s based on an article in JAMA based mostly on a report from the Heart for Healthcare High quality and Cost Reform. The report states:

Greater than half (55%) of the agricultural hospitals within the U.S. don’t provide labor and supply companies, 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 companies is below 20 minutes, however in rural areas, the journey time is more likely 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 influence not solely entry to care throughout supply, but additionally prenatal and post-natal care.

The absence of native maternity care companies is felt all through the continuum of obstetric care. Sufferers are much less more likely to receive satisfactory prenatal or postpartum care companies if they should journey lengthy distances.

“It’s one factor to say the mom has to drive half an hour to ship her child,” Miller mentioned. “It’s one other factor to say the mom has to drive a half an hour each month to have the ability to get prenatal care. They will’t take day without work of labor, can’t take time away from the children.”

https://jamanetwork.com/journals/jama/fullarticle/2815499

Why are rural hospitals dropping maternity care? Clearly the reply is that reimbursement is way beneath their value. Furthermore, discovering satisfactory staffing is troublesome.

Sustaining labor and supply companies requires having physicians and nurses, together with nurse anesthetists or anesthesiologists, who’re educated and accessible across the clock to handle deliveries as wanted. Consequently, funds per start which can be satisfactory at a big hospital should not sufficient to assist maternity care at small rural hospitals with far fewer births.
“We ship about 300 infants a 12 months, so a mean of lower than 1 a day, however you continue to must have OB-GYN protection twelve months a 12 months, 24 hours a day, 7 days every week as a result of infants come always,” Sinek mentioned in an interview. “It’s costing us $7.5 million proper now to workers our OB unit with nurses that know what they’re doing and CRNAs [certified registered nurse anesthetists] to do anesthesia companies and the workplace workers to assist that care. All of that’s actually including up, and in the event you don’t ship sufficient infants to cowl these prices, you then’re on a downhill course.”

…fewer obstetricians and household physicians with obstetric expertise are in a position or keen to be on name a number of nights and weekends out of each month…Consequently, hospitals both should make use of or contract with extra physicians or OB-GYN hospitalists.

https://jamanetwork.com/journals/jama/fullarticle/2815499

You may learn the total report right here.