Rural NC lacks OBGYNs. New UNC Health fellowship aims to change that
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- UNC Health is launching a two-year rural OBGYN fellowship focused on leadership training.
- Program targets care disparities as over 60% of rural NC women face long travel times.
- Fellows will split time between clinical care and academics at two rural hospitals.
UNC Health is launching an OBGYN fellowship dedicated to rural women’s health.
And it’s the first of its kind in the nation, according to a news release issued by the health system and Kavita Arora, director of the UNC Rural Obstetrics and Gynecology Fellowship.
“The goal of our fellowship is not necessarily how to train people clinically regarding how to do obstetrics and gynecology, that is the point of residency, but rather to train them to be leaders in rural OBGYN care,” she said.
She said the fellowship — which runs through the UNC School of Medicine — is designed to prepare physicians to handle the realities of rural practice — from limited resources and long travel distances for patients to the financial strains facing hospitals.
Fellows will also gain leadership training, learn to manage quality improvement projects, and be equipped to guide multidisciplinary teams, with the goal of closing care gaps and reducing disparities for rural patients, she told The News & Observer.
The fellowship will be a two-year program operating at two rural health care sites: UNC Health Rockingham and UNC Health Lenoir. UNC Health Rockingham is in Eden and serves Rockingham, Guilford and Caswell counties as well as Virginia’s Pittsylvania and Henry counties. UNC Health Lenoir is in Kinston and serves Lenoir County.
The fellowship will follow a 50% clinical and 50% academic structure, the release said.
Disparities in care
The fellowship comes as North Carolina faces high infant and maternal mortality rates, along with rural disparities in access to care.
Also concerning are funding challenges, Arora said.
“Rural maternal health disparities are especially critical given the number of maternity hospitals in the United States that have closed over the last decade, and I think with changes in funding — especially Medicaid funding — on the horizon, the likelihood of OB hospitals closing around the country is only going to go up rather than down,” she said.
More than one in five counties in North Carolina are considered maternity care deserts, meaning they have no hospital or birth center offering obstetric services and no obstetric providers. That is better than the situation nationally, with nearly a third of counties nationwide lacking such providers, according to the March of Dimes.
About 13.4% of women in the state live more than 30 minutes from a birthing hospital, higher than the national rate of 9.7%. And in rural areas across North Carolina, according to the March of Dimes, 60.1% of women live over 30 minutes away.
And roughly 17.1% of those who gave birth received no or inadequate prenatal care, above the U.S. rate of 14.8%.
“Early and regular prenatal care is critical for reducing the risks of pregnancy and birth complications,” Arora said in the news release.
North Carolina ranks 10th highest in infant mortality rates nationwide, according to a state report. Non-Hispanic Black and American Indian children have higher mortality rates than other groups. In 2023, Black babies died at rates three times higher than white babies, says the report.
Meanwhile, the state’s maternal mortality rate doubled from 2019 to 2021 during the peak of the COVID-19 pandemic, according to data from the Centers for Disease Control and Prevention. It peaked at 44 deaths per 100,000 live births in 2021, above the U.S. rate of 32.9 that year, The News & Observer previously reported. Black mothers die at higher rates.
“From office-based prenatal care to labor and delivery to gynecologic surgery, our medical fellows will provide hands-on care with patients as well as work on career development goals like quality training, healthcare finances, executive healthcare leadership development and research,” said Sachin Gupta, chief medical officer for UNC Physicians Network.
“They can also tap into the unparalleled resources offered within the UNC Health infrastructure across the state,” he said in the news release.
The program is accepting applications through March of next year, with interviews and selections on a rolling basis. According to the application site, fellows will receive individualized mentorship and training, drawing from UNC’s resources. Applicants must have a medical degree and have completed an approved OBGYN residency.
The aim is to have one fellow at each location, though more may be picked if there are multiple qualified candidates, said Arora.
This story was originally published August 27, 2025 at 8:00 AM.
