Rural communities face diminishing availability of obstetrical (OB) services. Nearly a third of rural counties in 2019 had no OB clinicians. Family physicians are the most common health professional providing rural OB care, but more than half of rural counties had no family physicians who delivered babies in 2019, and this number is declining. Delivery by family physicians is associated with lower rates of caesarian section births, indicating that this workforce is important not only to increase rural access to OB care, but also to improve quality and reduce costs. Meanwhile, the U.S. is experiencing a national shortage of obstetricians and gynecologists (OB-GYNs), again more acutely in rural areas. How widespread rural OB training is and how expansion of this training can best be supported are not well understood. This study seeks to describe the availability, characteristics, and output of rural OB training programs, including family medicine residencies and OB fellowships as well as OB-GYN. We identify barriers, facilitators, and solutions to support rural OB training. Study findings can help policymakers and rural health professional educators develop new initiatives to help ensure the availability of a robust rural OB workforce.