Women shoulder much of the responsibility for their families' health care, making women's satisfaction with available services an important issue for their families and for women's personal stress levels. Lack of services and resulting stress may be acute for rural women, the focus of this study. In a state-wide survey, fewer than one-half of rural women were satisfied with the health services available; dissatisfaction was a strong determinant of women's stress over health care issues. Rural women are at risk for a pile-up of stressors that could impede their ability to care for themselves and their families.