Rural Access to Obstetrical Care Act of 1991 - Requires the Secretary of Health and Human Services to: (1) provide for demonstration projects to reduce infant mortality by improving access in rural, underserved areas to obstetric services for eligible pregnant women under title XIX (Medicaid) of the Social Security Act; (2) develop and make available to the public each year a compendium of State initiatives to address the obstetric access crisis in rural areas; and (3) provide funding for a study, and report to the Congress on, obstetrical malpractice claims payment by Medicaid and private insurance companies.