Study reveals maternity care risks in rural America - Entrepreneur Generations

The years-long trend of rural hospital closures has led to worse health outcomes for women giving birth and their babies, according to a recently published study by the University of Minnesota's Rural Health Research Center. Though experts have long suspected this, the study is the first to provide proof, Katrina Pross reports for the Minnesota Daily.

Fewer than half of rural counties have a hospital where women can have a baby; the study found that between 2004 and 2014, 179 rural counties lost hospital-based obstetric services. It's one of the first departments struggling hospitals eliminate because of its expense. According to Diane Calmus, government affairs and policy manager for the National Rural Health Association, the large proportion of births covered by Medicaid in rural areas is part of the reason for this, since Medicaid doesn't fully reimburse hospitals for expensive births.

Because of this lack of maternity services, pregnant women in rural areas sometimes have to travel hours to receive the routine maternal care that can catch problems like pre-eclampsia or gestational diabetes, and bad weather can prevent them from getting to the hospital in time to give birth. They may be forced to give birth at a local hospital that doesn't have the proper equipment to care for a newborn in distress. In the year after a county lost hospital-based obstetric services, researchers found a significant increase in births at hospitals without OB services. The study also found an increase in delayed prenatal care initiation, pregnancy-based hospitalizations, premature births, low birth weight, and infant mortality.

"The NRHA is lobbying for a federal bill that would improve hospital reimbursement rates. The bill has already been passed by the House of Representatives but still needs to be passed by the Senate," Pross reports. One of the study's authors also recommended financial incentives to increase the number of health care workers trained in obstetrics in rural hospitals, as well as training local law enforcement and EMS workers in basic maternity care and implementing services to transport expectant mothers safely to hospitals.




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