More and more, people giving birth can’t count on their closest hospital having the specialized health care they need.

Researchers tallied losses and gains of labor and delivery units at close to 5,000 U.S. hospitals from 2010 to 2022. The losses prevailed. More than half of rural hospitals and more than one-third of urban hospitals did not offer obstetric services in 2022, researchers report December 4 in the Journal of the American Medical Association. That’s worse than in 2010, when 43 percent of rural hospitals and 30 percent of urban hospitals lacked these services.