# Effect of Losing Hospital-Based Obstetric Services on Maternal Health in Rural Communities

> **NIH NIH R03** · STATE UNIVERSITY OF NEW YORK AT ALBANY · 2022 · $151,382

## Abstract

Project Summary / Abstract
There are striking urban/rural disparities in access to hospital-based obstetric care in the US, and the
gap in access between urban and rural communities is growing. Access to hospital-based obstetric
care is critical to health outcomes before, during, and after pregnancy. Rates of severe maternal
morbidity and maternal mortality are rising in the US, particularly for mothers living in rural communities.
We know little about whether lack of access to hospital-based obstetric care may play a role in adverse
maternal outcomes in rural areas. This study has two goals. First, we estimate the effect of losing
access to hospital-based obstetric care in rural U.S. counties on maternal health outcomes measured
at the time of delivery, and test for disparities by race/ethnicity and by maternal education, using Vital
Statistics birth certificate records from 2005-2018. Second, we estimate the magnitudes of policy-
relevant factors affecting rural mothers’ health outcomes directly as well as indirectly through loss of
access to obstetric care; these policy-relevant factors include the state’s ACA Medicaid expansion
status, hospital characteristics, and local market characteristics. These findings are intended to provide
new information on the health consequences of rural hospital and obstetric unit closures, and how
public policies can be used to offset some of the impact.

## Key facts

- **NIH application ID:** 10450398
- **Project number:** 1R03HD106215-01A1
- **Recipient organization:** STATE UNIVERSITY OF NEW YORK AT ALBANY
- **Principal Investigator:** Chun-Yu Ho
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $151,382
- **Award type:** 1
- **Project period:** 2022-09-19 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10450398

## Citation

> US National Institutes of Health, RePORTER application 10450398, Effect of Losing Hospital-Based Obstetric Services on Maternal Health in Rural Communities (1R03HD106215-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10450398. Licensed CC0.

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