The OB/GYN shortage in the United States is no secret. A recent study examining the OB/GYN workforce underscores what hospitals and clinicians already feel. Recruitment is slowing, retention is eroding and access gaps are widening.

In a January 2026 study published in Obstetrics & Gynecology, researchers assessed the adequacy of the number of OB/GYNs across all U.S. states to forecast changes from 2025 to 2035, using the Health Workforce Simulation Model from the Health Resources & Services Administration and publicly available datasets.

• In 2025, the national supply met 93.4% of the demand, with significant geographic disparities
• By 2035, all but six states are projected to have an OB/GYN shortage
• Rural, nonmetropolitan areas are expected to experience a particularly severe shortfall

Despite this well-known pending healthcare crisis, many systems continue to address the future workforce shortage with a staffing mindset rooted in the past. “The biggest issue hospitals are having is they’re still looking at this the way we would have looked at it in 1985 instead of looking at the rest of the developed world as a model,” says Chief Clinical Officer of OBHG, Dr. Lisa A. Bukovac,

More incentives are just stop-gap measures

Hospitals across the country report that they cannot recruit OB/GYNs fast enough. At the same time, retention rates are declining, and burnout is increasing.

Expanding residency programs may help at the margins. Loan-repayment programs may temporarily attract candidates. Signing bonuses may buy time. Still, none of those strategies change the daily reality driving burnout across the OB/GYN workforce:

• Unpredictable call schedules
• Rising acuity
• Medical malpractice costs, lawsuits and nuclear verdicts
• Increasing administrative burden
• Shrinking reimbursement rates

If the OB/GYN role itself remains unsustainable, adding more physicians to the same structure doesn’t solve the problem. Addressing the growing workforce shortage requires a structural redesign.

Centralizing care is not the answer

As workforce pressure intensifies, some community hospitals are consolidating services with regional hospitals. On paper, centralization can appear efficient, but in practice, it widens disparities. “Closing rural hospitals is the absolute wrong thing to do because when we close them, we’re removing care from patients. The patients who suffer the most are the ones with the fewest resources,” says Dr. Bukovac.

The difference between a five-minute drive to a community hospital and a 45-minute drive to a distant academic center isn’t just inconvenient. In obstetrics, it can be deadly. “It could mean the difference between a healthy mom and baby or a tragic outcome,” says Dr. Bukovac.

These challenges are particularly acute in rural America but aren’t limited to these areas. Underserved urban communities often face similar gaps in reliable obstetric coverage. Whether in rural or metropolitan areas, limiting access to maternal care by closing maternity centers does little to solve the workforce strain and dangerously transfers risk to patients.

The OB hospitalist model as a workforce solution

Addressing a structural problem requires a structural solution. At OBHG, we’re already redesigning how obstetric care is delivered inside hospitals. The model separates hospital-based care from outpatient productivity pressures. OB hospitalists work 5 to 8 24-hour shifts per month in a full-time role with benefits. Rather than continuous on-call periods layered onto clinic schedules, OB hospitalists have plenty of time for work-life balance.

OB hospitalists also redefine the workforce more broadly. Community physicians who are supported by OB hospitalists are better able to balance office hours, deliveries and overnight calls. “The OB hospitalist model is the answer,” says Dr. Bukovac.

Expanding the OB workforce

The research study suggests integrating advanced-practice clinicians to mitigate staffing shortages. At OBHG, we’re already using all available OB/GYN providers, including OB/GYNs, midwives, NPs, PAs and family medicine OBs. “There are thousands of untapped professionals who can provide obstetric care, and they’ve been trained well to do it. It’s just a matter of having folks practice at the top of their license and building a team to support that community,” says Dr. Bukovac.

This isn’t supplemental staffing. It’s workforce infrastructure that increases the hiring pool while also strengthening existing employees. Having sufficient staff and allowing everyone to work within their scope of license improves job satisfaction and retention.

Protecting access without collapsing local systems

Structural redesign also opens new possibilities for maintaining access in underserved areas.

At OBHG, we’re deploying models that allow clinicians to live where they choose while providing periods of scheduled coverage in underserved areas, drawing patients living in maternity deserts. “This gives them the flexibility to remain living where they and their family choose to live, but still be able to provide care to women in underserved areas,” says Dr. Bukovic.

The concept mirrors international models, such as Australia, where rotating teams provide coverage in remote regions in the Outback. There, teams provide care for women in the Outback for a week, then return to their usual work or home, while another team goes in. Australia has one of the lowest rates of maternal morbidity worldwide. “What they’re doing is working, and I don’t see why we can’t mirror that here,” says Dr. Bukovac.

Technology, including health support, further extends expertise into vulnerable communities. OBHG recently launched Obtelecare, a telehealth platform providing virtual maternal-fetal medicine services to health systems nationwide. “Obtelecare represents the next evolution of our mission to ensure every mother has access to the level of care she needs, when she needs it,” says President and Chief Operating Officer of OBHG, Nick Sacco.

Together, these models can provide stable, predictable care that keeps hospitals open and communities served.

Quality and equity outcomes that exceed national benchmarks

Structural redesign is only meaningful if it produces measurable results. At OBHG, our outcomes meet or exceed national averages. For example, our NTSV cesarean rate is approximately 19.6%. The national average is about 26%, and the commonly cited benchmark goal is 23.6%, which OBHG already far exceeds.

“The results for our moms and babies surpass the rest of the nation,” says Dr. Bukovac.

In 2025, our care demonstrated clinical excellence at OBHG sites nationwide, ensuring better outcomes for more mothers and babies.

Equity data are equally striking

The OB shortage translates into a crisis in care, particularly among minority populations. At OBHG, standardized, evidence-based protocols and staff training ensure that all moms achieve the same outcomes across regions, races and socioeconomic status. “Our moms who are marginalized have the same outcomes as our Caucasian moms. We’re the only company that can prove that it doesn’t matter what a patient’s background is. They’re going to have the same care,” says Dr. Mark Simon, OBHG Chief Medical Officer.

Because OB hospitalists are payer-agnostic and not dependent on individual patient panels, care decisions aren’t influenced by reimbursement concerns. The result is standardized, evidence-based care applied consistently across populations. In a workforce crisis, quality and equity cannot be afterthoughts. They must be embedded into the model.

Supporting clinicians in a volatile environment

Workforce sustainability also requires psychological safety, as legal and political pressures in certain states have created uncertainty that can affect OB/GYN care. Research is already showing that care in states with more restrictive environments is experiencing accelerated attrition.

Residents are hesitant to train in states that restrict OB/GYN practice, and OB/GYNs are less likely to choose to work there.

At OBHG, we indemnify our clinicians. “If you’re caring for a woman, and you make the right clinical decision, OBHG will always have your back. That has helped us preserve our workforce,” says Dr. Bukovac.

Strengthening community improves retention

OB hospitalists may work overnight shifts or in distributed markets, but they aren’t isolated. At OBHG, clinical leaders, market meetings, peer-recognition platforms and virtual connectivity tools keep colleagues connected.  “We’re at the tip of the spear, and we’re changing the way maternal care is delivered in this country,” says Dr. Bukovac.

Structural change is the strategy for the future of OB care

The future of OB/GYN depends on building systems that protect both patients and the clinicians who serve them.

A more sustainable care structure across the U.S. can mean meeting and even exceeding the number of providers needed for the future of OB/GYN care. “Our company is giving me hope that meaningful change is possible. I’m watching it happen. As our scope continues to expand, we’ll be able to have a greater impact, and women will be better served because of it,” says Dr. Bukovac.

Ready to explore how OBHG could help support your hospital’s maternity care goals? Request a conversation here.