U of M fellowship aims to boost rural obstetrics training and keep labor and delivery units open

As more Minnesota rural communities lose local obstetrics services, the University of Minnesota Medical School and central Minnesota’s CentraCare hospital are teaming up to equip more rural providers with the skills they need to handle complicated births.

The partnership is launching the new one-year family medicine obstetrics fellowship next summer to prepare family medicine physicians to provide advanced prenatal, maternity and newborn care in rural communities. The only other fellowship of this kind in Minnesota is at Essentia Health in Duluth.

Keri Bergeson, director of rural programs for the University of Minnesota Department of Family Medicine and Community Health, said that while obstetric care can be provided by OB-GYNs, there are few of them in rural areas, so family medicine physicians provide the bulk of the care in rural areas.

“If you have a hospital that delivers 100 babies a year, you can't staff a team of OBs only, right?” Bergeson said. “There's not enough babies to keep them busy. So you need someone who can deliver the baby, but also take care of someone with pneumonia and then go to the clinic and see their panel of patients there.”

Bergeson and CentraCare’s Christine Goudge, director for the new program, said that’s why this sort of training is urgently needed. While family medicine providers do receive obstetric training, many don’t learn how to handle surgical cases, like C-sections.

“One of the things that really is key to any program is having providers that are able to take care of women when they're in labor and handle all the different emergencies that come up,” Goudge said.

Minnesota has been losing hospital-based obstetrics services at a faster rate than most states in the country, especially in rural areas, which are disproportionately affected, increasing the health risks facing people who are pregnant. A data analysis by University of Minnesota’s Rural Health Research Center found that 29 hospitals closed their obstetric units between 2010 and 2024, leaving just 56 percent of hospitals with labor and delivery units statewide.

For many rural hospitals, the financial equation of staffing labor and delivery units just doesn’t add up. Birthing centers tend to be too expensive to staff full time for the relatively few babies delivered each year, and it can also be challenging to attract providers to rural areas. Bergeson hopes the fellowship, which promises to put two highly qualified family physicians in rural labor and delivery units each year, will help prevent more units from closing.

“If rural hospitals have more opportunity to recruit the physicians they need with the skills to provide the care, then they're more able to maintain that service line,” Bergeson said.

Two board-certified family medicine physicians will be selected each year for the fellowship and will complete rotations at CentraCare clinics and hospitals, which serve a sizable, largely rural population in central Minnesota. They will receive high-volume surgical obstetric experience, as well as targeted training in neonatal resuscitation and perinatal mental health.

The first cohort of fellows will begin training in July 2027.

This fellowship isn’t the only initiative championed by the University of Minnesota and CentraCare Medical School Partnership to tackle the rural shortage of medical professionals.

In the summer of 2025, the University of Minnesota launched a new medical school in St. Cloud in partnership with CentraCare to attract more physicians to train, and hopefully work longer term, in rural areas. The new regional campus is the first expansion of the U’s medical school in more than 50 years since the Duluth campus opened in 1972.

Bergeson said the University of Minnesota is hoping to add additional rural medicine training tracks in partnership with CentraCare soon. They already have rural medical programs for pediatrics and psychiatry, and Bergeson said that a rural general surgery track was recently approved. And in the next few years, they’ll start recruiting for the first class of a rural internal medicine residency program.

“I really think that the University of Minnesota-Centracare Medical School Partnership is what's making programs like this [family medicine obstetrics] fellowship really ripe for development,” Bergeson said. “Because if we're getting more med students in the pipeline who are rurally facing and rurally focused, then we need rurally based programs for residency and fellowship to round out that training.”

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