Introduction
Access to high-quality US hospital–based perinatal care is limited, contributing to poor outcomes.1 Because perinatal care is often Medicaid-funded with high fixed costs for specialized units, its provision may create hospital financial strain.2 Strong hospital financial health, or a hospital’s long-term financial stability, is associated with improved adult care quality and outcomes, but its association with perinatal access and outcomes is unclear.3 We examined hospital provision of perinatal services stratified by hospital financial health, and the associated health policy of disproportionate share hospital (DSH) payments, which financially support hospitals serving high proportions of Medicaid patients. (Open Access)