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Abstract
Background Maternity service closure across Australia over the last 20 years has significantly impacted maternity care accessibility, particularly rural areas. How rural health service board members and executives consider maintaining maternity service is unknown. Aim To examine how rural Victorian (Australian) boards and health executives consider ongoing maternity service provision and factors that influence continued maternity operation or closure. Methods A cross-sectional online survey gathered perspectives from rural Victorian board members and health executives, with data analysed using descriptive statistics, correlation analysis, and thematic analysis. Findings Responses from 44 participants revealed that rural maternity workforce availability, funding, midwifery leadership, community factors, and regional health service support critically impact service continuation decisions. Discussion Findings highlight disconnects between prioritising continuity of care and implementing flexible workforce models like midwifery group practice. Critical deficits in workforce, leadership, and 24/7 theatre staffing challenge rural maternity service sustainability. Conclusion Targeted funding through regional partnerships and strong midwifery leadership are essential for maintaining accessible, safe rural maternity services.
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