The University of Minnesota study found that rural mothers have a 9 percent higher risk of severe childbirth outcomes, based on researchers' review of nearly 34 million birth outcomes across the nation from 2007 to 2015. "The disparity translates into 4,378 additional childbirth deaths and near-death complications among rural mothers during that period," Olson reports. Severe childbirth complications and deaths rose among rural and urban areas during that time period, increasing from 109 per 10,000 childbirth hospitalizations in 2007 to 152 per 10,000 in 2015, the study says.
The researchers found the 9% increase in risk for rural mothers after controlling for socio-demographic factors and clinical conditions. Blood-transfusion problems were a factor in a majority of the cases with poor outcomes, especially rural ones, Olson reports. That's significant because hemorrhages or excessive bleeding are a common cause of childbirth complications. Other factors related to difficult childbirths include the opioid epidemic, lack of transportation, poor housing, poverty, food insecurity, racism, violence and trauma.
At a recent symposium where she presented the findings, study co-author Katy Kozhimannil said the rate of childbirth complications and deaths is "unacceptably high." She noted that many hospitals have stopped delivering babies to save money, but said pregnant women near such hospitals receive less prenatal care and have to drive farther to give birth, Olson reports. "The hospital no longer holds the risk of a birth gone wrong, but that risk doesn’t leave that community," Kozhimannil said.