An interesting study published in the September issue of Health Affairs found that 9 percent of rural counties experienced the loss of all hospital obstetric services in the period 2004–14. In addition, another 45 percent of rural US counties had no hospital obstetric services at all during the study period. We took a slightly different angle and looked at the bassinets set up and staffed over a five year period from 2011 to 2015 and compared it to clusters (bins) of populations in increments of 20,000. The results are striking:

 

  • While 40% of the counties in the U.S. have under 20,000 residents, the number of bassinets set up and staffed relative to the population (population per bassinet) is about 63% lower. 

  • The number of bassinets staffed for these rural counties has declined 16.5% over the five year period compared to the national change of 3.2%. 

The table below shows this information which we assimilated using the Beds and Utilization Interactive. Note, we cut off the county population clusters at 300,000. 

 

The study goes on to state that rural counties with lower median household incomes, higher populations of black women, and those located in states with lower Medicaid income eligibility limits for pregnant women were the most likely to lose or have no obstetric services.