Rural hospitals across the country are shuttering their labor and delivery doors, leaving millions of women – including Mississippians – without maternity care.
The growing epidemic of closures hasn’t affected Mississippi as much as other states in recent years – but most of Mississippi’s rural hospitals already don’t deliver babies, according to a report from the Center for Healthcare Quality and Payment Reform, an organization that focuses on solving health care problems by reforming insurance payments.
Only one rural hospital in Mississippi closed its labor and delivery unit between 2021 and 2025, the report found. However, the vast majority – 68% – of rural hospitals in the state do not have a labor and delivery unit. Most of the 50 rural Mississippi hospitals not delivering babies never did, or stopped long ago, while four have closed their delivery services within the last 15 years.
Now, the problem that has plagued Mississippi is spreading across the U.S., where nearly two rural hospitals each month have stopped delivering babies since the end of 2020, and more are announcing closures for 2025. That’s more than 100 rural hospitals in just under five years.
Addressing rural maternity care is key to mitigating maternal mortality in America – which continues to have the highest rate among high-income nations, the report’s authors argued.
“Over 80% of pregnancy-related deaths are preventable with appropriate prenatal, labor & delivery, and post-partum care,” the report read. “Although improvements in maternity care are needed in all parts of the country to reduce mortality rates, one of the greatest challenges is in rural areas, because most rural hospitals are no longer providing maternity care at all.”
Across the country, less than half – 42% – of rural hospitals currently offer labor and delivery services.
The study also looked at travel times to labor and delivery units for women using the distance from hospitals without labor and delivery services to hospitals with those services. It found that in most urban areas, the travel time to a hospital with labor and delivery services is under 20 minutes. In rural areas, women face travel times of at least 30 minutes, but often 50 minutes or more.
At 35 minutes, Mississippi’s median travel time is similar to the country as a whole.
The rural hospitals that have stopped delivering babies in Mississippi since 2010, according to data from the Mississippi State Department of Health, are: the south campus of Anderson Regional Medical Center in Meridian; the community campus of Merit Health Natchez; Magee General; and Greenwood Leflore.
Despite Meridian being one of Mississippi’s larger cities, the Health Resources and Services Administration (HRSA) defines it as rural.
Authors of the study offered several recommendations to stakeholders, most of which centered around reforming payments to hospitals.
One of the biggest challenges for small hospitals providing maternity care is that physicians and staff must be standing by 24 hours a day, but are only paid when they deliver a baby – even though rural hospitals may experience many days when there are no deliveries.Another problem with payment methods, according to the report, is that insurance companies often pay more for C-sections, meaning hospitals and clinicians that support natural childbirth may lose money – even though there have been national efforts to reduce C-section rates, which are highest in Mississippi.
The report stressed that the biggest problem is not with Medicaid or uninsured patients. The primary cause of overall losses on patient services at rural maternity care hospitals is private insurance companies paying rural hospitals less than what it costs to deliver services to patients.
“Rural maternity care is in a state of crisis, and more women and babies in rural communities will die unnecessarily until the crisis is resolved,” the report stated. “Federal and state government officials and private employers must take immediate action to ensure that all health insurance plans are paying adequately to support high-quality maternity care in every community.”
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