“…This was especially important as recent evidence suggests the number of rural hospitals providing OB services may be declining because of decreasing reimbursement (National Advisory Committee on Rural Health and Human Services [NACRHHS], 2005) and increasing costs (Zhao, 2007). Recruitment and retention of nurses has been identi¢ed as a sig-ni¢cant challenge in small rural hospitals resulting in shortages of nurses (Hancock, Steinbach, Nesbitt, Adler, & Auerswald, 2009;MacDowell, Glasser, Fitts, Nielsen, & Hunsaker, 2010;Molinari & Monserud, 2008), however, no studies were found regarding availability of perinatal nurses in rural areas or nurse sta⁄ng of perinatal units in these types of hospitals.…”