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Gynecologist doing ultrasound of pregnant woman in hospital.

Rural hospital labor and delivery closures are creating maternity care deserts—and costing communities physicians, jobs, families, and economic investment.

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No Doctor, No Delivery, No Future

Today, less than half of rural hospitals in the U.S. still offer labor and delivery services, and since 2020, 139 of them have stopped delivering babies altogether. That's usually treated as public health statistic. It's also an economic one. Each closure doesn't just push expectant mothers into longer drives to the hospital, it pushes out physicians, jobs, young families, and the investment that follows them. So, what happens to a town after it loses its only labor and delivery unit?

The answer, it turns out, is a lot more than a longer drive to the hospital. More than a third of U.S. counties, 35.1 percent by the most recent national count, are now what researchers call maternity care deserts: places with no hospital or birth center offering obstetric care and no obstetric clinicians at all. Since the end of 2020, 139 rural hospitals have stopped delivering babies, and today less than half of rural hospitals nationwide still offer labor and delivery services.

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The All-America City of San Antonio Collaborates to Address Teen Pregnancy and Other Issues
person in green pants sitting on white textile
Photo by Vanessa on Unsplash

The All-America City of San Antonio Collaborates to Address Teen Pregnancy and Other Issues

San Antonio, TX, has been working to reduce teen pregnancy for over two decades, making considerable progress through collaborations among the city, county, nonprofit organizations, and the University of Texas. A nine-time All-America City, one of San Antonio’s key community collaborations, SA 2020, harnessed civic muscle to create and achieve dozens of measurable goals, including a significant reduction in teen pregnancy.

The San Antonio Teen Pregnancy Collaborative (SATPPC) was formed in 2010 in response to news that Bexar County had one of the highest rates of teen births in the United States. The SATPPC brought together an impressive list of cross-sector organizations, including public entities, community-based organizations, and faith-based and secular institutions. The group’s overall goal was to reduce the Bexar County teen birth rate among females ages 15 to 19 by 15% by 2020, and it exceeded this goal even before that date.

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In Milwaukee, J.D. Vance Ties Trump's Fraud Task Force to Medicaid and SNAP Crackdowns

U.S. Vice President JD Vance speaks at the 128th Air Refueling Wing Hangar on July 08, 2026, in Milwaukee, Wisconsin. Vance traveled to Milwaukee to deliver remarks on the Trump administration's anti-fraud initiatives.

(Photo by Scott Olson/Getty Images)

In Milwaukee, J.D. Vance Ties Trump's Fraud Task Force to Medicaid and SNAP Crackdowns

MILWAUKEE, Wisconsin– Vice President J.D. Vance visited Milwaukee on July 8 to promote the Trump administration’s crackdown on fraud at the state and federal levels in programs like Medicare and SNAP.

Speaking inside an aircraft hangar at the Wisconsin Air National Guard’s 128th Air Refueling Wing, in front of a banner reading “Protect Taxpayer Dollars,” Vance cast the anti‑fraud efforts to protect both taxpayers and the programs themselves.

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​U.S. Health and Human Services Secretary Robert F. Kennedy Jr.

U.S. Health and Human Services Secretary Robert F. Kennedy Jr. participates in a roundtable discussion on efforts to combat per- and polyfluoroalkyl substances (PFAS) with U.S. Environmental Protection Agency (EPA) Administrator Lee Zeldin at EPA headquarters on May 18, 2026 in Washington, DC.

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RFK Jr. Received Compassion When He Was Arrested for Heroin, but My Patients Do Not

In 1983, while on a flight to South Dakota, a 29-year-old Robert F. Kennedy Jr. was reported to have developed profuse sweating, pallor, and a weak pulse. Authorities searched his luggage and discovered two-tenths of a gram of heroin. He pled guilty to a felony charge, and the judge ordered him to two years of probation instead of a possible jail sentence. He entered rehabilitation for substance use and shared that since then, he has been in recovery for 43 years.

Robert F. Kennedy Jr. is now the U.S. Secretary of Health and Human Services (HHS). He has shown tremendous courage in sharing the story of substance use, including his LSD, methamphetamine, and heroin use. I cannot imagine the amount of stigma he has endured. I hope that his success encourages others to seek treatment. Yet as an addiction medicine physician, I am also struck by how different my patients' experiences are from those of Kennedy.

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