Table 2.

Reported Reasons for Rural Hospitals No Longer Doing Deliveries (N = 19)

	Number (%) of Respondent Hospitals
Reasons for closures†
Staffing issues	15 (79%)
Illustrative quotations:
“One OB retired and one moved. We didn't have the providers any more to offer this service.”
“Our facility stopped doing OB … mainly based off of the inability to maintain consistent surgical and anesthesia coverage.”
“We had two doctors and then one stepped away and we had a hard time recruiting. We had trouble with coverage for anesthesia as well.”
“We stopped doing deliveries because we only had one provider doing deliveries. We lost a provider (FP) who no longer wanted to do OB services and we've been unable to recruit new doctors.”
“too few staff or providers in the community to operate an OB unit”
Low birth volume	9 (47%)
Illustrative quotations:
“We had a small number of births.”
“… the volumes dropping to the point where nurse competencies were becoming difficult to maintain”
“It was based on low numbers and high malpractice insurance.”
“we averaged 18 births a year. Lacking experience and had to do a lot of training…”
Other financial issues	6 (32%)
“We were purchased by another system and it was a financial decision to close the OB department.”
“OB Dept closed … due to budget cuts and also because there were other OB providers fairly close by.”
“It wasn't making any profit and we have an older population.”
“We were in the middle of a financial turnaround and the new administration decided to stop for financial reasons.”
Low reimbursement rates	3 (16%)
“80% were Medicaid and 10% no pay.”

Bold indicates primary themes.

†Some hospitals reported more than one reason.