The Rural Maternity Care Crisis

By Corinne Lewis, Isabel Paxton, and Laurie Zephyrin, M.D.: For More Info, Go Here…

Americans living in rural areas often face barriers getting needed health care because of where they live. These barriers range from difficulty getting transportation to finding a provider that takes their insurance and has appointments available. As rural hospitals continue to close and the shortage of health professionals grows, it’s becoming harder for rural Americans to get the care they need.

These issues are particularly acute for an often-overlooked group: pregnant women.

What are the risks pregnant women in rural areas face?

Pregnant women living in rural America face unprecedented barriers to maternity care. First, hospitals are closing at an alarming rate; nearly 100 rural hospitals have closed their doors since 2010. Of those that remain, 20 percent are at risk of closing. Rural hospitals also are shutting down their obstetric (OB) units, leaving fewer than half of rural counties with such units.

These hospital and OB unit closures mean rural women in labor increasingly face lengthy journeys to the hospital, sometimes even hours long. They also have contributed to increases in births outside hospitals, births in hospitals without OB care, and in preterm births — all of which carry greater risks for mom and baby.

Experts believe these closures also contribute to early elective deliveries using induction and cesarean section — procedures that increase the risk of complications — because women do not want to risk going into labor when they are hours from the nearest hospital.

There is also a growing shortage of prenatal care in rural areas. Fewer than half of all rural counties have a practicing obstetrician or gynecologist (OB/GYN). This lack of prenatal care increases the likelihood by three to four times that women will die a pregnancy-related death, and contributes to higher rates of infant mortality. The scarcity of rural OB/GYNs also means rural women have poor access to postpartum care. This is alarming since one-third of maternal deaths happen one week to a year after giving birth.

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