The Maternal Health Care Crisis: A Rural Women’s Issue

Travel back with me, if you will, to a chilly evening in the year 1995. It’s December 24^th and for one woman, Christmas is about to come early. My mom, LucilleontheBall Sr, finds herself rushing through the snow to give birth to her second child. Although she was not due to deliver for another few weeks, my mom was met with immediate care at the hospital doors and successfully delivered a healthy child. Due to her close proximity to a hospital that housed a prepared and fully-funded maternity ward, my mom was able to deliver her child without any complications.

My mom was lucky. However, for the nearly 2.4 million women living in rural counties of America, their luck is quickly running out.

Last May, NPR and ProPublica conducted a six-month long investigation into the increasing maternal mortality rates that plague the U.S. Among their list of findings, perhaps most startling was the fact that women in America are dying of pregnancy-related complications more than any other developed country. While the study attributed causes of this problem to low federal and state funding and an overall lack of comprehensive training for doctors in the field of maternal-fetal medicine, women like Claire Shirley demonstrate that this issue has another major contributor: geography.

Shirley is a resident of Grand Marais, a rural county in Minnesota where, less than one month before discovering that she was pregnant, the local hospital announced that they were closing the doors to their maternity ward for good. After a contraction woke Shirley in the middle of the night, she and her husband had to make a quick decision: travel over two and a half hours to the nearest hospital with a maternity ward, or head over to the local hospital where there was no OB/GYN or anesthesiologist on duty. Although Shirley and her husband had prepared to travel to the maternity ward in Duluth, the baby was on its way early and, unlike my mother, their chances of making it safely to the hospital were low. Thankfully, Shirley made it in time to safely deliver her newborn child, Kit.

While Shirley’s story has a happy ending, that’s simply not the case for most women in rural areas across the country. A study from the journal Health Affairs, puts this crisis into perspective. Over the past decade, the percent of rural counties, like Shirley’s, that lack a hospital with obstetric services has increased 54%. In other words, 2.4 million women without sufficient maternal care, simply because of where they live.

There are several factors that contribute to this problem. Financially, low state and national funding are a major issue. However, because over half of the births in America are covered by Medicaid (which pays doctors back at much lower rates than private health insurance plans) many hospitals cut their maternity wards simply because they aren’t seeing the return on their investment. This factor also affects the hospital’s ability to recruit and retain staff.

While organizations such as Mission Health and the University of Wisconsin’s School of Medicine and Public Health are taking great strides to combat this issue, it is crucial that we continue to explore solutions. In this post, I’ve highlighted several resources that can help you educate yourself and others on this topic. Check them out, share this post with your friends, and most importantly, keep the conversation going- because every mother deserves the chance to leave the hospital with their child.