Minnesota Maternity Care Closures
About 126,000 reproductive-aged women in Minnesota live in counties without hospital-based obstetrics care, according to data released by the University of Minnesota’s Rural Health Research Center.
The total represents a 48 percent increase since 2010, when the research center began tracking hospital labor and delivery unit closures across the state, mprnews.org reported. That figure is likely an undercount because the data only runs through 2024, and additional birthing centers have closed since then.
Mayo Clinic permanently closed its labor and delivery unit in Fairmont in southern Minnesota in 2025. Sanford Health announced last week that it will stop delivering babies at its Luverne clinic near Sioux Falls next year.
Longer Drives Increase Health Risks for Pregnant Patients
Longer drives to reach a hospital increase health risks for pregnant patients and their babies. Julia Interrante, a researcher and statistical lead at the research center, said that people living in these counties must travel much farther distances to give birth.
Sometimes that’s 30 minutes. Sometimes it’s hours,
Interrante told mprnews.org.
Sometimes we see these births happening out of the hospital setting. Sometimes that’s planned, but sometimes it’s not. More patients [are] giving birth on their way to the hospital, or even just showing up at emergency rooms in hospitals that don’t have regular obstetric services, which can have its own risks if those hospitals aren’t prepared for those emergency birth situations,
Interrante said.
Driving longer distances also leads patients to defer prenatal and postpartum visits more frequently. That pattern increases the risk of preterm birth, which endangers both mother and infant.
In 2024 alone, 6,500 women in Minnesota living in counties without local obstetrics care gave birth. Those patients accounted for 11 percent of all births statewide that year.
Financial Pressures on Rural Units
Rural areas have absorbed the heaviest losses in Minnesota and nationwide. The University of Minnesota found that between 2010 and 2024, 301 counties nationwide lost hospital-based obstetrics services, with rural communities accounting for 228 of those closures. Fourteen of those closed units were located in Minnesota.
High operating costs drive many rural hospitals to shutter their birth centers. Staffing a labor and delivery unit with doctors, nurses, and 24/7 personnel capable of handling complicated births is expensive, as is paying for liability insurance.
Attracting physicians, particularly obstetrician-gynecologists, to remote locations remains difficult. Rural hospitals also deliver fewer babies, making units cost much more to operate than they generate in revenue.
Rural hospitals treat a higher proportion of patients on Medicaid. Medicaid pays less for labor and delivery services than most private health insurance plans do.
A lot of rural hospitals have been struggling financially for a long time. A swing of 20 or 30 births from year to year can mean a huge change in the revenue for that hospital in terms of being able to keep maternity services available,
Interrante said.
Contrasting State Trends
Minnesota has lost obstetric units at a higher rate than most other states, leaving it with one of the highest percentages of rural hospitals that do not offer labor and delivery services. Interrante explained that this trend partly reflects Minnesota’s stronger starting position in 2010 compared to other states.
Even after recent closures, more than half of Minnesota’s counties still contained at least one hospital with obstetrics care as of 2024. In neighboring North Dakota, by contrast, 84 percent of rural counties and 50 percent of urban counties lacked hospital labor and delivery services.
Some rural facilities continue to expand their maternity care. United Hospital District in Blue Earth, located just north of the Iowa border, reported that it is on track to double the number of babies it delivers compared to five years ago. Northfield Hospital + Clinics and CCM Health in western Minnesota described similar success in growing their delivery numbers.
United Hospital District achieved this by cross-training staff to work across departments when labor and delivery units are quiet, helping cut high staffing costs.
New Training Fellowship Program
To address the shortage of physicians trained for high-risk deliveries in rural areas, the University of Minnesota Medical School and CentraCare in central Minnesota are launching a new rural obstetrics fellowship program. The initiative will train family medicine physicians to deliver advanced prenatal, maternity, neonatal, and postpartum care in rural communities.
Interrante expressed support for such training efforts. During a previous survey of rural hospitals to determine why obstetrics units closed, she found that physician shortages ranked as the primary reason.
Having those rural residency programs and hopefully increasing the likelihood that people are training and staying and providing maternity care in rural communities, will help that,
Interrante said.
Common Questions About Rural Closures
Why are rural hospitals closing labor and delivery units?
Maintaining 24/7 staffing, covering high liability insurance costs, and recruiting specialized physicians in remote areas create steep financial burdens. Rural facilities also deliver fewer babies overall and treat a high volume of Medicaid patients, whose insurance reimburses maternity care at lower rates than private plans.
How many Minnesota women are affected by these closures?
About 126,000 reproductive-aged women in Minnesota live in counties lacking hospital-based obstetrics care, according to 2024 data from the University of Minnesota’s Rural Health Research Center. In 2024 alone, 6,500 women residing in those counties gave birth.
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