Children are often described as our future. But in many rural communities across America, pregnant people are traveling farther from home to deliver babies. Since the end of 2020, 124 rural hospitals have closed or announced plans to eliminate their labor-and-delivery units — that’s about two a month. As small hospitals struggle with rising costs and staffing shortages, obstetrics departments are often among the first services to disappear.

In this encore episode of Us & Them, host Trey Kay hears from families living with those changes — and explores what the loss of maternity care could mean for the future of rural towns and communities.

This episode of Us & Them is presented with support from the West Virginia Humanities Council and the CRC Foundation.

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Two adults, a man and a woman, pose for a photo. She is wearing a red dress, and white sweater, and is visibly pregnant. The man is wearing a red shirt and slacks. — **Amy Staton** and her husband, **Jacob Staton**, pose for a photo in Williamson, W.Va., in 2023. At the time, Amy Staton was pregnant with their second set of twins while living in a community without local obstetric services. The Statons delivered their first child at Williamson Memorial Hospital, but the hospital ended OB care before later pregnancies, leaving the nearest hospital with a neonatal intensive care unit about 40 minutes from their home.

*Photo courtesy of Amy Staton*

Two adults, a man and a woman, and three children, two girls and a boy, pose for a photo. They are dressed up in formal attire, the girls are in dresses, and the boy is wearing a tie. The woman is visibly pregnant. — **Amy Staton**, her husband **Jacob Staton** and three of their children pose for a photo in Williamson, W.Va., in 2023. At the time, Staton was pregnant with another set of twins. The Statons welcomed their first child in 2014. The twins came two years later — with a pregnancy that carried higher risks for medical complications. In the years between those pregnancies, Williamson Memorial Hospital, about five minutes from their home, stopped offering obstetric services. That left the nearest hospital with a neonatal intensive care unit about 40 minutes away. The Staton’s youngest children were born at 34 weeks and spent time in neonatal intensive care units before returning home. They are now 2½ years old.

*Photo courtesy of Amy Staton*

“With twins you are considered high risk. You get more ultrasounds, more doctor’s appointments, more bloodwork and tests.

…Every appointment means taking time off work and driving 30 to 45 minutes. And it does go through your mind — how am I going to get there if I go into preterm labor? What happens if I don’t make it?

At least give us a place to say, if I need you, you're there. Give us the comfort of knowing I will be okay if something happens.”

— Amy Staton, medical assistant at Williamson Health and Wellness Center and mother of five

A middle age man with salt and pepper hair poses for the camera. He is wearing a blue and white checkered button up shirt, and a stethoscope is around his neck. He is wearing gray jeans. — **Dr. Dino Beckett**, CEO of Williamson Health and Wellness Center and a practicing family physician, is shown in Williamson, W.Va. Beckett says obstetric and prenatal services are often among the first to disappear when rural hospitals face financial pressure. Williamson Memorial Hospital stopped offering obstetric services in 2014 and closed during the COVID-19 pandemic in April 2020. The facility was later purchased and reopened by Williamson Health and Wellness Center as part of an effort to restore local health care services.

*Photo Credit: Trey Kay/West Virginia Public Broadcasting*

“None of us were happy [about the closing of Williamson Memorial Hospital]. Two of my children were born at that hospital. It was something the community didn’t want to lose.

But when you look at it financially, obstetric services are some of the hardest for rural hospitals to sustain. They require specialized staff, equipment and doctors available around the clock.

…Hospitals reach a point where they have to decide whether they can continue providing those services or risk losing the ability to offer other care altogether.”

— Dr. Dino Beckett, CEO of Williamson Health and Wellness Center and family physician in Williamson, W.Va.

Learn more about the Williamson Health and Wellness Center.

Carrie Cochran-McClain, chief policy officer for the National Rural Health Association, has spent more than two decades working on rural health policy in the United States. Her work focuses on the challenges facing communities like Williamson, W.Va., where access to services such as obstetric care have been eliminated.

Photo courtesy of the National Rural Health Association

“Rural health is a microcosm of what we see in our larger health care delivery system. We’re seeing more and more closures of rural facilities — entire hospitals, but also hospitals that once provided maternity care.

What has historically been a challenge is becoming more difficult in many of our communities. When a hospital loses services in a rural area, it affects far more than health care — it impacts jobs, economic development and whether families can continue to live there.”

— Carrie Cochran-McClain, chief policy officer, National Rural Health Association

Learn more about the National Rural Health Association.