Wednesday, April 27, 2011

Closures of rural maternity wards leave expectant mothers with few options

Rural women may be facing a shortage of adequate, accessible maternity care as more rural hospitals across the country close their maternity wards. In Hyden, Ky., Mary Breckinridge Hospital, named for the woman who helped bring the midwifery model of care to the U.S., closed its ward last year. "The hospital cited poor reimbursement from Medicaid, large malpractice insurance premiums for maternity care providers, and fewer births," Kelli B. Haywood reports for the Daily Yonder. Virginia, Ohio and Alabama also have seen maternity ward closures in recent months. (Haywood photo: Jaxon Shell at Mary Breckinridge Hospital)

"While there may be fewer births in some rural areas, it must be recognized that these areas are still underserved when it comes to maternity care," Haywood writes. The Center for Rural Health, a unit of the University of Kentucky, reports just seven obstetricians serve every 100,000 rural Kentuckians. In the state's urban areas the ratio is 11 to 100,000. Due to this disparity, "Rural women will face added problems and expense of transportation and child care if they hope to receive prenatal care," Haywood writes. "These costs could be high enough that some rural women, especially those who either are uninsured or who rely on government assistance for proper maternity care, would not be able to obtain it."

Research suggests medical intervention, like inducing labor or performing Cesarean surgery, is more common during births at rural hospitals where providers feel pressure from high patient loads. Haywood concludes, "Rather than fighting to keep a system that is not benefiting rural women, health care providers, or state governments, we need new models of care and ways in which that care can be obtained safely, close to home." (Read more)

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