J Rural Health. 2025 Sep;41(4):e70099. doi: 10.1111/jrh.70099.
ABSTRACT
PURPOSE: To identify and analyze facility-level strategies that support the sustainability of rural maternity and delivery care programs in the United States.
METHODS: This qualitative, cross-case study draws from data collected during the March 2024 Rural Maternity Innovation Summit in Clifton, Texas. Six rural health care organizations from diverse geographic regions shared their approaches to sustaining maternity and delivery services. Data include transcripts and presentation materials from summit sessions involving clinical, financial, and operational representatives of 6 rural hospitals. Thematic analysis was applied to identify cross-site strategies.
FINDINGS: Three core themes emerged: financial sustainability, workforce development, and community engagement. Strategies included maximizing payment mechanisms, forming partnerships with Federally Qualified Health Centers, employing family physicians with obstetric training, establishing rural residency pipelines, and implementing culturally responsive community outreach. These practices were adapted to local contexts but shared a focus on aligning maternity and delivery services with broader organizational and community goals.
CONCLUSION: Sustaining rural maternity and delivery care requires an integrated approach that combines financial acumen, strategic workforce development, and strong patient and community engagement. Facility-level innovations offer replicable strategies for improving maternal health access and outcomes in rural settings.
PMID:41388613 | DOI:10.1111/jrh.70099
