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Pregnant women

Emergency Physicians Face Challenges in Caring for Pregnant Patients at Rural Hospitals

Strategic Insights

— 1 min read

Rural hospitals across the United States have been closing their obstetric services, leaving emergency physicians without adequate training to care for pregnant patients. A study from Tufts University School of Medicine highlights the importance of immediate medical screening, stabilization, and transfer of patients to hospitals with obstetric services. In cases where transfer is not possible, emergency physicians must be equipped to provide basic obstetric emergency care.

Key Takeaways:

  • More than 50% of rural critical access hospitals in the United States no longer provide inpatient obstetric services.
  • Emergency physicians working in hospitals without inpatient obstetric services need to have knowledge of nearby obstetric units and regional maternal centers.
  • Level I Obstetrical Units (low-risk units) can typically accept patients with more than 37 weeks gestation, while Regional Maternal Centers (Level III/Level IV) can accept patients at any gestational age.
  • Emergency physicians must be familiar with both low-risk and high-risk centers in their catchment area.
  • The study emphasizes the need for emergency physicians to have knowledge of the closest obstetric unit they can transfer a patient for delivery and stabilization.

Statistics:

  • 50% of rural critical access hospitals in the United States no longer provide inpatient obstetric services.
  • Patients with gestational ages above 37 weeks can be transferred to Level I Obstetrical Units.
  • Patients with gestational ages of any age can be transferred to Regional Maternal Centers (Level III/Level IV).
  • Emergency physicians must have knowledge of both low-risk and high-risk obstetric centers in their catchment area.

Sources:

  • Research from Tufts University School of Medicine, Evaluation, Stabilization, and Transfer of Pregnant and Postpartum Patients Presenting to Emergency Departments Without Inpatient Obstetric Services. Annals of Emergency Medicine, 2025.
  • Personality contact information for the journal Annals of Emergency Medicine is: Mosby-elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA.
  • Additional authors for the research include Guy Nuki, Nathan Mick, Kelley Conroy, Maria D. Padin, Emily Watson and Regan N. Theiler.

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