Rural hospitals often lose maternity care after being bought

The Fitzgibbon Hospital in Marshall, Missouri mirrors an unfortunate national trend: “Rural hospitals are more likely to lose maternity care after they are acquired.” Fitzgibbon, which delivered 252 babies in 2025, filed for bankruptcy and was sold to a new owner, Strawberry Fields REIT, and a new operator, American Medical Administrators, Meg Cunningham reports for The Beacon.

In April, the hospital filed for bankruptcy protection, leading to the sale of its facilities. “Just nine days after the sale closed in early September, Fitzgibbon’s new operator announced the hospital would end labor and delivery services at the end of the month.” More than half of Missouri’s counties have no labor and delivery care. As larger hospitals absorb the responsibility of providing maternal services, ruralites will have to drive two or more hours to receive care.

During the sale, offers to buy the Fitzgibbon went up to $14.5 million, but ultimately, the administration accepted Strawberry Fields and American Medical Administrators’ offer of $10 million because the groups had expressed interest in continuing care using Medicaid. Medicaid covers 47% of births outside of metropolitan areas in the state.

The sale was not finalized at its Aug. 31 deadline because the new owners raised concerns about Fitzgibbon’s operating costs. To avoid closing the hospital, Fitzgibbon sued to force the sale through, then alleging American Medical Administrators had proposed cutting services, reducing outpatient care and backing away from Medicare commitments.

Dr. Abdullah Arshad, the chief medical officer at American Medical Administrators, said it later became clear the hospital couldn’t sustain maternal care after reviewing costs. The hospital will have the emergency equipment to handle a birth, and will staff a 24/7 OB-trained nurse, which Arshad said is rare in rural hospitals.