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UNC School of Medicine’s Cristy Page, MD, and Adam Zolotor, MD, co-authored this NEJM Catalyst article on UNC Health’s innovative maternity unit.


Amid a trend of closures of rural maternity units across the United States, UNC Health launched an innovative maternity unit in a rural county with a high rate of infant mortality to address a critical public health issue.

NEJM Catalyst published this article co-authored by Cristy Page, MD, MPH, executive dean of the UNC School of Medicine and the William B. Aycock Distinguished Professor of Family Medicine, and Adam Zolotor, MD, DrPH, professor of family medicine.

More than one-half of women in rural communities do not have access to local hospital obstetrical care, increasing the risk of poor health outcomes. Despite these increased risks to moms and babies, rural maternity units continue to close. The authors describe a model in which a state public academic health system opened a rural maternity unit and illustrate how maternity care in a Critical Access Hospital (CAH) can be positively positioned to benefit the CAH, the health system, and the community. The program design was based on seven supportive factors that collectively created a robust continuum of maternity services and a strong case for sustainability. With the loss of hospital obstetrical services in rural counties, devising innovative strategies to sustain and launch maternity units in rural communities is a critical public health priority.

The entire article is available only to NEJM subscribers.