Document Type

Honors Project - Open Access


The United States is experiencing a maternal health crisis that disproportionately affects those who give birth in rural communities. Rural birthing people have higher maternal mortality rates, increased risk of postpartum hemorrhage, non-indicated cesarean sections, and other adverse health outcomes. Despite the enhanced risks of rural birth, rural communities are losing access to hospital-based obstetric care at an unprecedented rate. Minnesota has vast rural territory, with one-fourth of its population living outside the urban sphere ­– making it a strategic area of study. As of July, 2021, 31% of Minnesota’s 91 rural hospitals were at risk of closing. The repercussions of obstetric loss reverberate through rural communities, leaving indelible physical, emotional, and economic impacts. This paper seeks to identify why American rural communities are experiencing the loss of hospital-based obstetric services and how local communities in rural Minnesota respond to the lack of maternal healthcare. Using a mixed-methods approach, this paper compares findings from a systematic literature review to survey responses and ethnographic interviews with birth workers and birthing people across Greater Minnesota. This research intentionally seeks out and uplifts rural knowledge to highlight the resiliency of Greater Minnesota. Findings from interviews suggest that communities identify macro-level issues as barriers to equitable, high-quality care. Minnesota’s rural communities respond to the maternal health crisis with place-based and community-specific public health measures. This study highlights the lived experiences and local knowledge collectively held by rural communities and provides critical insights into the reality of rural birthing across Minnesota.



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