Rural hospitals are less likely to offer obstetric services after they’ve been acquired by a larger health system, leading to mixed outcomes for mothers and babies, according to new research.

It’s part of an accelerating trend that’s reshaped how Americans get health care: Larger health systems gobble up smaller facilities in a bid for financial stability.

“The hospital industry has undergone tremendous transformation over the past few decades, with nearly 1,600 mergers between 1998 and 2021,” said Martin Gaynor, a coauthor of the study and emeritus professor of economics and public policy at Carnegie Mellon, in a statement.

Those large-scale changes to the health system can affect costs, quality and access to care, he said.

Over the past five years, more than 100 rural hospitals have

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