Three Great Lakes states have used Section 1115 Medicaid waivers to underwrite a quiet but significant rebuild of rural obstetric care over the past 18 months — not by reopening shuttered labor-and-delivery units, but by funding hub-and-spoke networks anchored at regional referral centers.
The approach, modeled loosely on a Norwegian system, pairs mid-sized hospitals with critical-access partners that retain triage and stabilization capability without operating full L&D services.




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