As the use of new technology increases and doctors and scientists know more than ever before, healthcare practices should in theory be getting safer and more prominent. Literacy and education related to pregnancy is growing. More information on obstetric care is increasing. Obstetric care is crucial for women’s health, the World Health Organization describes that basic essential obstetric care should include “parenteral antibiotics, parenteral oxytocic drugs, parenteral sedatives for eclampsia, manual removal of placenta and manual removal of retained products” (WHO 2000). There is a more comprehensive list, but the previous examples are essential. In April of 2017 the University of Minnesota Rural Health Research Center conducted a study on the loss of obstetric services in the United States, which disproportionately affect rural counties. This study’s information came from the American Hospital Association, where about 6,300 hospitals spread throughout the United States reported on loss of obstetric care. Because hospitals and obstetric care services are rapidly declining, should more obstetric care be implemented in rural areas?
Compared to micropolitan area, rural counties are losing obstetric services at a much faster rate. The number of hospitals that provide obstetric services declined by 25% in eleven years (RHRC). Rural counties are being more isolated not only because of hospital closures, but because obstetric care is not being offered to these communities, mostly in noncore areas. The findings also saw a trend that obstetric unit closure is more likely in counties with low birthweight and lower median household income. This is important to look at because it brings into question the lack of services that are essential to providing obstetric care for women. The chart below shows distribution among micropolitan and noncore rural areas. The loss of obstetric services in noncore areas are significantly higher than micropolitan areas.
This study calls for a need to asses obstetric care on a regular basis, however does not provide information about how many women now lack access to obstetric care. This study shows that hospitals and obstetric care is decreasing in rural counties, but it does not focus on other variables affecting women’s health. There are a lot of other variables and demographics that would be helpful to measure to determine what essential obstetric care services women do not have access to and are in need of. A more comprehensive study could identify the essential care that is lacking, and possibly improve obstetric care for women in rural areas.While there are micropolitan areas and urban communities, most of the United States is considered to be rural counties. The populations of people are vastly different and it is crucial to provide access to obstetric care to all women to reduce the risk of pregnancy.
This study does a good job at representing rural counties in the United States because there are approximately 3,000 counties in the United States, so this is a representative sample of counties. It also highlights not only hospitals that have been shut down in rural communities and therefore do not offer obstetric care but count for closures of just obstetric units. The data from this study overall show that there is a need to extend obstetric care in rural counties even though women demographics were not included in this study.
References:
http://rhrc.umn.edu/wp-content/files_mf/1491501904UMRHRCOBclosuresPolicyBrief.pdf
https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm
https://www.acsh.org/news/2017/10/25/infant-mortality-25-higher-rural-areas-12031
Data/Society/Decision-making Spring 2019 