Abstract
(JAMA. 2018;319(12):1239–1247) Between 2004 and 2014, hospital-based obstetric services have decreased from 55% to 46% in rural counties in the United States. Prior studies have shown that women and children in remote rural areas have delayed prenatal care initiation and higher rates of pregnancy hospitalizations, low birth weight, preterm births, and infant mortality. This retrospective cohort study examined whether the loss of rural obstetric services was associated with changes in location of childbirth or outcomes of care.
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