Across the country, rural hospitals are struggling to sustain obstetric services in the face of mounting workforce shortages, financial pressure and clinician burnout. For many communities, the question is no longer how to improve maternity care—it’s whether labor and delivery services can remain open at all.
These challenges are a major contributor to the growing number of maternity care deserts, where pregnant patients lack reliable access to prenatal, delivery, and postpartum care. According to the March of Dimes, limited access to maternity services is associated with more than 10,000 excess preterm births between 2020 and 2022, increasing risks for both mothers and infants.
At the same time, reductions in federal Medicaid support following recent funding redistribution have placed additional strain on rural hospitals and safety-net providers already operating on thin margins. For OB programs, where staffing costs are high and volumes can fluctuate, the impact is especially acute.
A pivotal moment for rural maternal health investment
The $50 billion Rural Health Transformation Program (RHTP), administered by the Centers for Medicare & Medicaid Services (CMS), arrives at a critical moment. Designed as a five-year initiative, RHTP provides states with flexible funding to modernize rural care delivery and stabilize essential services.
In December 2025, CMS announced that all 50 states will receive RHTP awards. As states move from planning to implementation, they must identify initiatives that are ready to deploy, operationally realistic, and capable of delivering measurable impact.
For maternal health, this means prioritizing solutions that keep labor and delivery units staffed, safe, and sustainable—particularly in communities where traditional OB coverage models no longer work.
MHAS: addressing the core challenge—OB coverage stability
Ob Hospitalist Group’s Maternal Health Access Solutions (MHAS) was developed specifically to help rural and smaller hospitals sustain obstetric services in today’s challenging environment. MHAS offers a flexible, customized approach to OB coverage that adapts to each hospital’s size, patient volume and clinical needs.
Rather than relying on a traditional OB hospitalist model, MHAS helps hospitals respond to workforce shortages, reduce clinician burnout and maintain consistent OB coverage through tailored staffing strategies. The result is a more resilient approach to keeping labor and delivery services available—without forcing hospitals into models that don’t fit their reality.
At Kittitas Valley Healthcare in rural Washington, the planned retirement of all three full-time OB/GYNs placed the hospital’s labor and delivery unit at risk of closure. Through MHAS, the hospital transitioned to a rotation-based staffing model that restored reliable OB coverage and preserved access to maternity care for the surrounding community.
This kind of stabilization is essential not only for patient access, but also for hospitals’ long-term viability.
Creating a foundation for broader maternal health transformation
Stabilizing OB coverage is often the first step in rebuilding rural maternity care. Once hospitals can reliably staff labor and delivery units, they are better positioned to invest in additional capabilities—such as telehealth, specialty consults, and care coordination—that further improve outcomes and keep care local.
In this way, MHAS serves as a foundational strategy within broader state maternal health efforts under RHTP, enabling rural hospitals to adapt, sustain services, and participate fully in transformation initiatives.
Turning RHTP funding into durable maternal health access
If states want meaningful maternal health gains from the Rural Health Transformation Program, they must invest in solutions that address the day-to-day realities of rural hospitals. Flexible OB staffing models like MHAS offer a practical, deployable way to stabilize access, support clinicians, and protect labor and delivery services—now and for the future.
Rural families deserve dependable maternity care close to home. The Rural Health Transformation Program provides states with the opportunity to act—and Maternal Health Access Solutions help turn that opportunity into lasting impact.
Extending access to high-risk expertise through Obtelecare
While stabilizing frontline OB coverage is essential, many rural hospitals also struggle to provide consistent access to maternal-fetal medicine (MFM) specialists—particularly for high-risk pregnancies. Even hospitals with reliable labor and delivery staffing often lack the volume or resources to support an on-site MFM practice.
OBHG’s Obtelecare addresses this gap by extending MFM expertise into rural settings through a tele–maternal-fetal medicine model that integrates seamlessly with local care teams. Because the majority of MFM care can be delivered remotely, Obtelecare enables earlier identification of complications, faster clinical decision-making, and more timely interventions—without requiring patients to travel long distances for specialty consults.
When paired with MHAS, Obtelecare becomes even more effective. Stabilized OB coverage ensures that local teams are consistently available to act on specialist recommendations, manage complex cases, and coordinate care across the pregnancy continuum. This combination helps keep care local whenever it is safe to do so, while ensuring patients still have access to high-risk expertise when needed.
Under the Rural Health Transformation Program, this layered approach—stabilizing OB services first through MHAS, then expanding specialty access through Obtelecare—offers states a scalable, practical path to strengthening maternal health systems across rural communities.
Put RHTP funding to work for rural maternity care
Interested in using Rural Health Transformation Program funding to stabilize rural obstetric services? Let’s talk about how Ob Hospitalist Group’s Maternal Health Access Solutions can help your hospital maintain labor and delivery coverage and preserve access to maternity care across rural communities.