Rural Health
Research Gateway

Maternal health

Completed Projects

Listed by project completion date. You can also view these projects alphabetically.

2024

  • How are Rural Health Clinics Serving Pediatric and Obstetrical Medicaid Populations?
    This project examined the roles of independent and provider-based Rural Health Clinics in serving pediatric and obstetrical patients covered by state Medicaid programs.
    Research center: Maine Rural Health Research Center
    Topics: Children and adolescents, Health services, Healthcare financing, Maternal health, Medicaid and CHIP, Rural Health Clinics (RHCs), Women
  • Rural Obstetric Unit Closures
    The goal of this project was to update prior research to include the latest information on the loss of hospital-based obstetric services in rural U.S. counties. This project is important because ensuring obstetric care access and reducing maternal mortality in rural and underserved areas is a key focus of national, state, and local policies.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals (CAHs), Healthcare access, Hospitals and clinics, Maternal health, Women, Workforce
  • Rural-Urban Differences in Domestic Violence as a Contributor to Maternal Morbidity and Mortality
    Using 2016-2020 data from the CDC's Pregnancy Risk Assessment Monitoring System, this project assessed the prevalence of domestic violence among rural and urban residents who give birth. We also analyzed how screening and support services could be improved to support rural families that experience domestic violence, including during pregnancy and the postpartum period.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Maternal health, Social determinants of health, Violence and abuse, Women
  • Rural/Urban and Racial/Ethnic Inequities in Patient-Reported Health Care Access and Quality among Medicare Beneficiaries with Lung or Colorectal Cancer
    Incidence and mortality for colorectal and lung cancer are higher among rural versus urban residents, but many rural cancer patients lack accessible, high-quality care. This study 1) Identified rural/urban inequities in Medicare cancer patient-reported health care access and quality and 2) Determined if rural racial/ethnic minority patients have worse health care access and quality than rural White patients.
    Research center: Rural and Underserved Health Research Center
    Topics: Cancer, Health disparities and health equity, Healthcare access, Maternal health, Medicare, Minority health, Quality

2023

  • Improving Racial Equity for Rural Mothers and Infants
    The purpose of this project was to assess differences in maternal and infant health outcomes and access to perinatal care, among urban and rural counties. We also compared health outcomes and availability of services, including evidence-based services and supports, between rural counties that are majority Black, Indigenous, and People of Color with those that are majority white.
    Research center: University of Minnesota Rural Health Research Center
    Topics: American Indians and Alaska Natives, Critical Access Hospitals (CAHs), Health disparities and health equity, Healthcare access, Hospitals and clinics, Maternal health, Minority health, Rural statistics and demographics, Social determinants of health, Women
  • Overcoming Barriers to Providing Rural Obstetrical Training for Physicians
    Rural communities struggle to maintain obstetrical (OB) services, due in part to scarce rural training opportunities for obstetricians and family physicians. This study described the availability, characteristics, and output of residency and fellowship programs offering rural OB training and identified solutions to support this training.
    Research center: WWAMI Rural Health Research Center
    Topics: Healthcare access, Maternal health, Physicians, Women, Workforce
  • Rural/Urban Differences in Postpartum Health Insurance, Healthcare Use, and Health Outcomes
    The purpose of this project was to identify rural/urban differences in health insurance, healthcare use, and health outcomes among postpartum individuals, and to describe policy-relevant implications or strategies to improve insurance coverage, receipt of recommended healthcare, and, ultimately, health outcomes among rural residents who give birth. With a lens towards health equity, all analyses were stratified by race/ethnicity and income.
    Research center: University of Minnesota Rural Health Research Center
    Topics: American Indians and Alaska Natives, Health disparities and health equity, Healthcare access, Healthcare financing, Hispanics, Hospitals and clinics, Legislation and regulation, Maternal health, Medicaid and CHIP, Minority health, Private health insurance, Women

2022

2021

  • A Current Examination of HIV and Hepatitis C in Rural Counties
    Using data from federal and state sources, we produced a chartbook on county-level data on human immunodeficiency virus (HIV) prevalence and acute hepatitis C virus (HCV) incidence, examined the availability of Ryan White HIV/AIDS medical providers and other HIV and HCV treatment/testing services across the rural-urban continuum, and estimated county-level prevalence of maternal HCV infection.
    Research center: Maine Rural Health Research Center
    Topics: Maternal health, Mental and behavioral health, Substance use and treatment
  • Predictors and Barriers to Achieving Immunization in Rural and Urban Areas
    Prenatal and timely childhood immunizations offer the optimal strategy for preventing severe morbidity and mortality due to vaccine-preventable disease. This project evaluated possible gaps in immunization services for pregnant women and their infants in rural areas as compared to urban areas.
    Research center: Southwest Rural Health Research Center
    Topics: Children and adolescents, Health promotion and disease prevention, Health services, Maternal health
  • Trends in Preterm Birth by Rural Status in the U.S.
    This project determined rates of preterm birth by rural versus urban residence and across census regions. The project also examined the relationship between preterm birth and maternal characteristics, including race and ethnicity as well as pregnancy complications among women in rural versus urban residence.
    Research center: Southwest Rural Health Research Center
    Topics: Health disparities and health equity, Maternal health, Women

2020

  • Emergency Obstetrics in Communities Without Hospital-Based Maternity Care
    The purpose of this project was to describe rural hospitals that do not provide obstetric services and to survey a sample of these hospitals regarding their capacity for emergency obstetrics locally in order to inform policy to support access to high-quality maternity care for all pregnant rural residents.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Healthcare access, Hospitals and clinics, Maternal health, Quality, Women
  • Making It Work: Models of Success in Rural Maternity Care
    The purpose of this project was to update information on access to obstetric services in rural counties, to identify common factors across rural communities that have maintained local hospital-based obstetric services, and to describe best practices associated with successfully supporting birth locally in rural communities.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Healthcare access, Hospitals and clinics, Maternal health, Quality, Women
  • The Supply and Rural-Urban Distribution of the Obstetrical Care Workforce in the U.S.
    This project will use multiple data sources to characterize the distribution of the obstetrical care workforce in the U.S., comparing health professional-to-population ratios in rural and urban areas. Health professionals examined in this study include obstetricians, family physicians, and certified nurse midwives.
    Research center: WWAMI Rural Health Research Center
    Topics: Healthcare access, Maternal health, Physicians, Workforce
  • Women, Infants, and Children (WIC) 2009 Food Package Revisions on Participants in Rural Areas with Extreme Poverty Levels: Impact on Infant Breastfeeding, Infant Feeding, and Health Outcomes
    This study examines the effects of the revised Women, Infants, and Children (WIC) Program food packages on breastfeeding rates among WIC participants in areas designated as rural, with high levels of extreme poverty and food deserts, and/or high rates of those who are overweight and obese.
    Research center: Southwest Rural Health Research Center
    Topics: Children and adolescents, Maternal health, Poverty, Women

2019

  • Developing Rural-Relevant Strategies to Reduce Maternal Morbidity
    The purpose of this project was to distinguish and analyze predictors of maternal morbidity during childbirth hospitalization by geography and to develop recommendations to improve the safety of childbirth for rural residents. It also assessed the degree of rural focus and representation in current policy efforts to address this crisis.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Health disparities and health equity, Health services, Healthcare access, Hospitals and clinics, Legislation and regulation, Maternal health, Quality, Women

2018

  • Rural-Urban Differences in Opioid-Affected Pregnancies and Births
    This analysis aimed to combat the opioid epidemic in rural communities by describing the rates and predictors of non-medical opioid use prior to and during pregnancy and maternal diagnosis of opioid use disorder at birth, based on rural or urban maternal residence and rural or urban hospital location.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Maternal health, Substance use and treatment, Women

2017

  • Are Rural Mothers and Infants Benefiting from Changes in National Women, Infants and Children (WIC) Policy?
    This study explored breastfeeding practices among rural participants in the Women, Infants and Children (WIC) Program before and after a federal policy change in WIC Food Packages. National Food and Nutrition Survey data was used to examine the potential impact on breastfeeding, infant feeding practices, and food/beverage consumption.
    Research center: Southwest Rural Health Research Center
    Topics: Children and adolescents, Maternal health, Poverty, Women

2016

2014

  • Obstetric Care Practice Models and Quality in Rural Hospitals
    The project will examine current obstetric practice models in rural hospitals and assess the prospects for implementation of new policy recommendations for reducing primary cesarean rates and non-medically indicated inductions of labor in rural hospitals.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Maternal health, Quality

2013

  • Quality of Obstetric Care and Perinatal Safety in Rural Hospitals
    The project will use both national and state-level hospital discharge data to examine obstetric care quality and perinatal safety in rural U.S. hospitals, with an in-depth focus on rural hospitals in a nationally representative group of eight states across all four U.S. Census regions.
    Research center: University of Minnesota Rural Health Research Center
    Topics: Critical Access Hospitals (CAHs), Maternal health, Women

2012

2008

  • Changes in U.S. Rural Perinatal and Infant Health Care During the Last Decade
    This study examined changes in rates of adverse birth outcomes and prenatal care among rural Americans of different racial and ethnic groups during two time periods. The study used national data from the Linked Birth Death Data Sets to assess differences in low birth weight, neonatal death, post neonatal mortality and inadequate prenatal care.
    Research center: WWAMI Rural Health Research Center
    Topics: Children and adolescents, Health disparities and health equity, Maternal health

2006

  • Declining Access to Hospital-based Obstetric Services in Rural Areas: Causes and Impact
    This study examines the declining availability of hospital-based obstetric services in rural areas from the mid-1980s to the early 2000s. It examines potential causes for this trend and explores the effects of medical malpractice reforms.
    Research center: NORC Walsh Center for Rural Health Analysis
    Topics: Hospitals and clinics, Legislation and regulation, Maternal health, Women

2005

2004

2003