At this year’s American Hospital Association (AHA) Rural Health Care Leadership Conference, one message was clear: access to care for women in rural communities remains under pressure.
With more than half of rural counties lacking hospital-based obstetric services and over 130 rural hospitals closed since 2010, leaders spoke candidly about sustainability challenges, workforce shortages, and the difficult tradeoffs required to keep essential services available. As highlighted in Fierce Healthcare’s November 2025 article, “When the hospital leaves town,” the loss of local healthcare services doesn’t just affect patient access—it reshapes the economic and social fabric of entire communities.
More than 35% of U.S. counties are now classified as maternity care deserts, and women living in those areas are the most likely to receive inadequate prenatal care. That broader context framed many of the conversations at AHA.
Access to care has economic ripple effects
One healthcare executive who stopped by our booth shared a perspective that underscored how deeply maternal care access is tied to community sustainability.
Her hospital rarely delivers babies and is located roughly 60 miles from the nearest delivery center. Expectant mothers often travel elsewhere to complete prenatal care and deliver. She shared that her organization is actively looking to expand prenatal services because access plays a role in attracting and retaining young professionals. With many transient nurses cycling through, she emphasized the desire for stability: if prenatal care were available locally, it could help young families put down roots. “We want them to stay,” she said. “If we had prenatal care, that would help.”
Her comments reflect a broader truth. In maternity care deserts—where consistent prenatal access is already limited—communities struggle to recruit workforce talent, retain young families, and sustain long-term growth. Prenatal care is not simply a service line—it is part of a community’s foundational infrastructure.
Expanding access in a constrained workforce environment
Recruiting and retaining specialists—particularly maternal-fetal medicine (MFM) physicians—continues to challenge rural systems. With most MFMs concentrated in metropolitan areas, many hospitals lack consistent access to high-risk pregnancy expertise.
For women in maternity care deserts—already at higher risk of inadequate prenatal care—limited specialty access can compound disparities, affecting early detection, care coordination, and outcomes. Leaders acknowledged that these gaps influence not only operations, but clinical confidence, continuity, and patient trust.
Maternal-fetal medicine telehealth as a strategic complement
Many executives expressed growing interest in technologies like telehealth as part of a sustainable solution. The conversation has shifted from whether virtual care works to how it can be integrated effectively to strengthen local teams and expand access.
For maternal care, teleMFM models can support hospitals across multiple settings. If a patient presents to labor and delivery with severe hypertension at 32 weeks, an MFM specialist can connect in real time to guide evaluation and management decisions. If a first-time mother in a rural community is identified as high-risk during a routine prenatal visit, she can complete a scheduled outpatient consult locally rather than traveling hours for care. And beyond individual encounters, virtual MFMs can participate in multidisciplinary rounds, review complex cases, and collaborate with on-site clinicians to align protocols and strengthen care delivery.
For communities classified as maternity care deserts, this type of embedded subspecialty support can help close access gaps while preserving care close to home whenever clinically appropriate.
Importantly, leaders emphasized the need for solutions designed for long-term stability—models that integrate into existing workflows, align with quality standards, and endure beyond temporary funding cycles while preserving care close to home.
A shared commitment to keeping care close to home
Rural hospitals are not looking for temporary relief—they are looking for sustainable ways to protect access to care for women and families in their communities. Expanding maternal-fetal medicine support through collaborative, technology-enabled models is one practical step toward that goal. When specialty expertise can be integrated into local workflows, hospitals are better positioned to strengthen outcomes, support clinicians, and keep care close to home.
To learn how Obtelecare can partners with your hospital to expand access to maternal-fetal medicine, visit obtelecare.com/for-partners.
