Protect Our Care counts 52 US maternity ward closures since HR1 announcement

96 rural counties could lose labor and delivery units

Maternity wards across the United States are facing a wave of closures as cuts to federal Medicaid funding take effect, experts have warned, and they expect more closures of maternity units in the run-up to and after the federal changes to Medicaid come into effect in the new year. Protect Our Care, a nonprofit, has counted 52 ward closures since the HR1 bill was announced in July 2025, with a further eight having announced their upcoming closure.

The bill, which will fully come into effect in the new year, will require many adults covered through Medicaid to meet new work requirements and be subject to more frequent eligibility checks, while providing less federal funding for states’ Medicaid programs. Hospitals that have already permanently closed their maternity wards include Centra Southside Community Hospital in Virginia and St Mary’s Sacred Heart Hospital in rural northeast Georgia, both of which cited upcoming federal policy changes to Medicaid as a reason.

“We’re deeply concerned that these changes already have and will continue to worsen an already serious maternity care crisis,” said Erin Jones, senior director of legislative and strategic counsel at March of Dimes. “Reduced funding and restrictions on how states finance Medicaid will put additional pressure on state budgets and hospitals, increasing the risk that communities lose essential maternity services and specialized providers close to home.”

Jones said the consequences for maternity care would be particularly devastating within rural communities. March of Dimes has identified 31 at-risk rural hospitals with labor and delivery services; their possible closure would leave 96 counties without a labor and delivery unit. “Losing these services means fewer places to deliver safely and fewer options for pregnancies requiring specialized care,” she said.

Medicaid pays for about 40% of births in the United States, and the country has one of the highest maternal mortality rates among high-income nations — 17.9 deaths per 100,000 live births, according to the latest figures from the Centers for Disease Control and Prevention.

Benjamin Sommers, a professor of healthcare economics at the Harvard TH Chan School of Public Health, said the changes to Medicaid would “absolutely” affect women who are pregnant and specialist pregnancy organizations. “It’s not true that this law in any way protects Medicaid for pregnant mothers, for low-income parents. It adds financial strain to the providers and the insurance program that they rely on,” he said.

Sommers, who served as deputy assistant secretary for health policy under Joe Biden, said that although the new work requirements for Medicaid are supposed to exempt pregnant women, his research has shown that many women are not enrolled in the Medicaid pregnancy pathway, meaning the state might not know they are pregnant. “Someone could be enrolled through Medicaid expansion, they could get pregnant and they could mistakenly think – because they heard it on the news that this law doesn’t affect pregnant people – [they’re] fine, and it turns out the state doesn’t know they’re pregnant and they lose coverage,” he said.

Vaishu Jawahar, director of policy and programs at Protect Our Care, said the scale of the cuts forces hospitals into difficult decisions. “When you’re cutting Medicaid by a trillion dollars, you’re cutting this money from hospitals. So these hospitals are going into the red and being forced to make hard decisions, which usually results in maternity wards being closed as they are extremely expensive to run,” she said.

The federal actions extend beyond funding. In early 2025, the entirety of the CDC’s pregnancy risk assessment monitoring system team — which oversees a population-based surveillance system collecting data on women’s experiences before, during and after pregnancy — was placed on administrative leave by the Trump administration. According to an upcoming report by academics and former CDC staff seen by the Guardian, the actions disrupted the collection and management of “one of the nation’s most important sources of population-based information on pre-pregnancy, pregnancy, postpartum experiences, and maternal and infant health,” a system that has existed for over four decades.

Rita Hamad, professor of social epidemiology and public policy at the Harvard TH Chan School of Public Health and co-author of the report, said the loss leaves researchers without a way to study recent trends. “There are no other datasets like it. Teams like mine used to have access to this data before the portal was shut down, and so now there’s no way to study the more recent trends in maternal and infant health,” she said. “Now we’re very worried that the cuts to US safety net policies or barriers that keep people able to access those programmes are going to have detrimental effects on maternal and infant health.” She added: “I think we’re going to see those geographical and maternal disparities widening. Or we’re not going to see it because we don’t have the data, but that’s what is going to happen.”

The Guardian said the Department for Health and Human Services had been contacted for comment. The Guardian article included a photograph of people protesting against Medicaid cuts in Washington DC on 26 June 2025.