A new report has found that seven Arkansas counties have completely lost their obstetric service since 2010, while another 40 counties consistently had no maternity care throughout the study period. Those are just a few of the findings from the University of Minnesota Study which tracked the decline of hospital-based obstetric services across the country.
As Little Rock Public Radio reports, the research found just 35% of rural Arkansas counties have adequate obstetric care. Researcher Julia Interrante explained, “We have seen between 2010 and 2023, 641 hospitals that lost their obstetric units, and 286 of those were in rural communities. So you can see that rural communities are really overrepresented in places that have lost access to local maternity services.”
The study, however, did not stop at simply identifying the problem. It also offered concrete policy solutions which are fairly universal in application to improve maternal service in rural areas. Interrante serves as the statistical lead at the University of Minnesota’s Rural Health Research Center. She points to the creation of a financial support system in struggling areas. Such an effort can help establish a baseline of support that’s necessary to fill the void between the cost of essential services and what community partners can help fund, to bridge the gap.
Interrante explained, "Things like having cost-based reimbursement or having some sort of low-volume payment adjustment or standby payments to help cover those fixed costs, even when the number of births is too low to cover those fixed costs. And other things like having resources and training for emergency obstetrics, because some areas may have lost maternity care services, and it may not be viable for those services to return to those communities.”
According to the Center for Healthcare Quality & Payment Reform, most rural hospitals in the U.S. no longer deliver babies. It’s a decline decades in the making, that’s only accelerated, because of rising costs. The organization says traditionally, hospitals lose money on obstetrics, largely because, “It is expensive and complicated for any hospital to have labor and delivery because it’s a 24/7 service,” said the center’s president and CEO, Harold Miller. Typically, those costs had been offset by more profitable services. But these days, as Miller has concluded, “You can’t subsidize a losing service when you don’t have profit coming in from other services.”
In November 2025, Governor Sarah Huckabee sanders applied for $1 billion in federal funding for the Rural Health Transformation Program. It is a $50 billion investment in rural health care and public health that was included in the 2025 budget reconciliation law. As Gov. Sanders explained, the funds would help compensate for the deep cuts to Medicaid. “There’s an expectation that every state will get at least $500 million. We certainly think we’ve met the criteria to do that, but I’m hopeful that we will go above and beyond and get additional funding beyond that because of the work that we did collaboratively with so many stakeholders around Arkansas.”
Arkansas’ application focused on areas such as medical residency slots, workforce and telehealth. As for the timeline on when a decision could be made about the federal grant money. Governor Sanders says she’s not certain if they will know the amount of funding by the start of the fiscal legislative session coming up in April 2026.
