Rural areas with local access to obstetrical care report better infant health outcomes, including lower infant mortality rates and fewer babies delivered underweight. The retrospective cohort study compared the birth outcomes of rural counties in Alabama with in-county obstetrical care to those without over a 12-year span from 2003 to 2017.
Across all four outcome measures—including infant, perinatal, and neonatal mortality rates as well as low birthrate deliveries—counties with access to obstetrical care had significantly better infant birth outcomes. The authors were not able to control for race or other social factors and report that areas with no obstetrical care access were also more likely to have a higher percentage of underrepresented minority residents. This study does not prove a causal link between access to obstetrical care and infant health outcomes, but it does suggest that obstetrical access may play a role in these disparities.
These findings have broader implications for the more than half of all rural counties in the United States that do not have access to hospital-based obstetrical care.