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Rural hospitals in the United States are at an alarming rate, with maternity wings the first to go when budgets need to be balanced. The cost of keeping maternity wings open is significant for many cash strapped, rural counties because obstetric services need to be staffed and operational 24/7.

According to the , 80 percent of rural counties in states like Florida and North Dakota have no access to hospitals with obstetric services, to drive miles in the throes of labor, end up in emergency rooms with no obstetric care, or deliver outside of a hospital all together. New and expecting mothers are less likely to access prenatal and postnatal care because of this distance.

Rural, black women have substantially higher maternal mortality rates than white, urban women, one of the many tangible costs of not having access to these services. The United States overall has the rate in the developed world.