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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.