A total of 23 counties across the Commonwealth do not have labor and delivery units.
According to the Center for Rural Pennsylvania, 23 of Pennsylvania’s 67 counties do not have a hospital with a labor and delivery unit. Each of those 23 counties are classified as rural ones.
A report from the Chartis Center for Rural Health revealed that between 2011 and 2024, Pennsylvania lost 42% of its rural obstetrics units.
“When we ask CEOs why, it’s very expensive, it’s very risky and increasingly difficult to provide the high level of service and technology and everything else that’s needed to go along with that care,” said Michael Topchik, the executive director of the Chartis Center for Rural Health.
“We haven’t seen a statistical correlation, but we do see alignment directionally. I use the term bellwether, it’s a canary in a coal mine, so to speak. Because what’s happening is, hospitals are struggling to maintain a positive margin, and they shed services in order to protect their financial position,” he added.
Dr. Ethan Gable works as an obstetrician and gynecologist in Northcentral Pennsylvania. He serves Tioga and Potter Counties.
“Part of the [operational] challenge has been that the birth rates have been declining. We need a certain volume, even just from the clinical space to keep competencies,” he said in a recent interview.
UPMC Cole stopped offering labor and delivery services in April last year and now directs patients to UPMC Wellsboro. Warren General Hospital in Warren County closed its labor and delivery unit last year. The problem is only growing more severe.
“There’s a total of eight contiguous counties, which are home to around 35,000 women in the chilbearing age who now lack local labor and delivery services. To put that into perspective, that eight-county region is larger than the size of Connecticut,” said Zachary Adams, the executive director of the Center for Rural Pennsylvania in a recent interview.
The eight counties include Cameron, Clarion, Clinton, Elk, Forest, McKean, Potter, and Warren counties.
Other counties that lack labor and delivery services are Susquehanna, Sullivan, Wyoming, Carbon, Pike Northumberland, Carbon, and Snyder counties, and more.
According to the Center for Rural Health, residents of counties that do not have labor and delivery services travel an average of 27 miles to the nearest hospital with that service. Some are forced to travel far greater distances.
Also according to the Center for Rural Pennsylvania, 2023 data from the Health Resources and Services Administration showed that there were six OB/GYNs per 100,000 people in rural Pennsylvania. In urban areas of the state, that number increased to 16 OB/GYNs per 100,000.
Last year, President Trump announced a $50 billion Rural Health Transformation Program to strengthen and modernize health care in rural communities across all 50 states. The funding was included in the president’s One Big Beautiful Bill that was signed into law on July 4.
“Today marks an extraordinary milestone for rural health in America. Thanks to Congress establishing this investment and President Trump for his leadership, states are stepping forward with bold, creative plans to expand rural access, strengthen their workforces, modernize care, and support the communities that keep our nation running,” said CMS Administrator Dr. Mehmet Oz in a press release announcing the rewards.
The program aims to strengthen the rural clinical workforce, modernize its technology, and deliver care to underserved rural areas that need it the most.
For FY2026, Pennsylvania was awarded $193,294,054 from the fund.
