Rural North Carolina counties are seeing growing deserts of health services for women at local hospitals, with serious health implications. Multiple pressures are driving this trend. But solutions may be available.
Deserts of health care services for women have grown over the last decade in North Carolina, primarily in rural counties. To understand this trend, Carolina Public Press obtained and analyzed data for every hospital in the state through a public records request. A growing number of hospitals have reduced or eliminated labor and delivery units and OB/GYN services. These losses represent a health concern for rural communities. But attracting and retaining a medical workforce in rural counties also represents a challenge. And these services for women typically lose money, making them an easy target when hospitals need to slash costs. North Carolina lacks state regulations and incentives that could help encourage different decisions from health care executives. But if North Carolina can find the right solutions, including ideas that are working in other states and policy proposals already under discussion here, the potential to halt or reverse the desertification of women’s health care in rural counties exists.
Deserting Women is a three-part investigative series from Carolina Public Press, being published daily beginning March 17, 2025. The series has been made possible in part through grants from the Harry L. and Helen M. Rust Charitable Foundation and the Fund for Investigative Journalism, as well as the generosity of readers like you.
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Deserts for women’s health care services expand in rural NC counties
NC data shows labor and delivery and other women’s services reduced or eliminated at rural hospitals, with negative health implications.
Financial pressures prompt women’s services cuts at NC rural hospitals
Women’s services often lose money for NC rural hospitals. State doesn’t track lost services or require hospitals to sustain care.
Too costly to keep, but too important to lose. Solving paradox of NC rural women’s health services
Reversing trend of NC rural women’s health care services drying up will require tracking, enforcement and incentives in policies and laws.
Resources for the Deserting Women series
The map below shows the level of labor and delivery services at hospitals in North Carolina by county, also noting counties with no hospitals and counties where the level of service has changed over the last decade. The map is based on Carolina Public Press analysis of hospital licensing records submitted to the North Carolina Department of Health and Human Services and obtained by CPP through a public records request. Graphic by Mariano Santillan / Carolina Public Press
Contributors
This series is produced by the news team of Carolina Public Press
Reporting by Jane Winik Sartwell
Photos by Melissa Sue Gerrits, Colby Rabon, Jane Winik Sartwell and Lucas Thomae
Illustration by Mariano Santillan
Graphics by Mariano Santillan
Editing by Frank Taylor and Mike Kernels
