New Report by Stroudwater Associates Underscores Lack of Obstetrics Access in Texas

PORTLAND, Maine - Amzeal -- Stroudwater Associates, the nation's leading source for operational, financial, quality, and clinical strategy for rural and community healthcare, has released the Rural Texas Obstetrics Study, a report that details the challenges of rural obstetrics (OB) programs in the state of Texas, echoing the realities seen across rural America.

The report was funded by and developed in collaboration with the T.L.L. Temple Foundation. Additional partners included the Texas Organization of Rural & Community Hospitals (TORCH), the National Rural Health Association (NRHA), and the Federal Office of Rural Health Policy (FORHP). This report aims to identify the specific pain points faced by rural hospitals who hope to preserve access to obstetrics care within their communities.

"In East Texas, more than 80,000 residents do not have access to an in-region labor and delivery program, and many rural OB programs are at risk or have already closed," says Kevin Lambing, Senior Program Officer for Health Services at T.L.L. Temple Foundation. "By raising awareness of the rural health landscape, we can preserve access to obstetrics care in rural areas across the country."

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The study examined the impact of geographic access; program and hospital closures; maternal-fetal health and variation in access to services and health outcomes compared to United States averages; financial analysis of closed rural OB programs; provider shortages, focusing on OB-GYN physicians and advanced practice providers (APPs) with OB-GYN specialization; and a number of other challenges illustrated in conversations with rural hospital leaders across the state of Texas.

One of the key findings revealed that as a result of 15 rural OB programs closing in Texas between 2012 and 2024, an additional 97,000 Texas residents now reside more than an hour from the nearest labor and delivery program. In the counties experiencing the greatest concentration of accessibility issues, there was an increased rate of fetal mortality and a greater percentage of low-birthweight babies than the Texas state average.

"Many rural OB programs are struggling with increasing costs, staffing shortages, and flat demand for labor and delivery services," emphasized Stroudwater Associates' Managing Director, Jeff Sommer, MPP. "By researching and documenting rural obstetric program innovations, we are leading the way in preserving access to obstetrics care."

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This report was created as a companion to the Rural OB Innovation Summit, which occurred in 2024. Stroudwater Associates convened six rural health systems that were employing innovative practices to maintain and deliver OB care to their communities at a single location to present what they did and how they did it. An initial version of this report was presented as a part of this program. Policymakers, hospital leaders, stakeholders, and academics joined the event to learn from the presentations and participate in the discussions.

To download the full reports, please click here: https://www.stroudwater.com/white-paper/rural-texas-obstetrics-study/

About Stroudwater Associates

Founded in 1985, Stroudwater Associates is a leading national healthcare consulting firm with an all-encompassing devotion to rural healthcare nationwide. With corporate offices in Portland, Maine, and Nashville, Tennessee, and experience working in all 50 states, we focus on strategic, operational, clinical, quality, and financial areas where our perspective offers the highest value for rural hospitals, community hospitals, healthcare systems, and large physician groups. Our consulting teams offer deep expertise and broad experience in strategic, financial, clinical, and operational areas.