Maternal health: Rural Health Research Products & Journal Articles

2024

Information for Rural Stakeholders About Access to Maternity and Obstetric Care: A Community-Relevant Synthesis of Research
University of Minnesota Rural Health Research Center
Date: 09/2024
This document aims to inform rural stakeholders about challenges related to access to and quality of hospital-based childbirth care in rural U.S. communities.
Pediatric and Pregnancy-related Visits at Rural Health Clinics in 2018 Among Medicaid/CHIP Enrollees in 20 States
Policy Brief
Maine Rural Health Research Center
Date: 09/2024
This policy brief reports on the percentage of Medicaid-enrolled children and reproductive age women with pregnancy-related service use who visited a Rural Health Clinic in 2018 in 20 states.
The Availability of Midwifery Care in Rural United States Communities
Journal Article
University of Minnesota Rural Health Research Center
Date: 07/2024
In this paper, researchers addressed the limited understanding of the current landscape of rural midwifery providers, describing the availability of local midwifery care in rural U.S. communities using a national survey of rural U.S. hospitals.
Loss of Hospital-Based Obstetric Services in Rural Counties in the United States, 2010-2022
University of Minnesota Rural Health Research Center
Date: 07/2024
The purpose of this infographic is to show the loss of hospital-based obstetric services in rural counties from 2010 to 2022, and how this differs by rural county type (micropolitan vs. noncore).
Rural-Urban Differences in Midwifery Care During Childbirth in the U.S.
University of Minnesota Rural Health Research Center
Date: 07/2024
This infographic provides a snapshot of rural-urban differences in midwife-attended births, including changes over time as access to rural obstetric care declined and severe maternal morbidity and mortality rose across the United States.
Health Insurance Coverage and Experiences of Intimate Partner Violence and Postpartum Abuse Screening Among Rural U.S. Residents Who Gave Birth 2016-2020
Journal Article
University of Minnesota Rural Health Research Center
Date: 05/2024
Rural residents are known to experience higher rates of intimate partner violence (IPV) than their urban counterparts, and IPV contributes to maternal injury and death. In this paper, researchers examine the relationship between perinatal health insurance, intimate partner violence, and postpartum abuse screening among rural U.S. residents.
Intimate Partner Violence in Rural Communities: Perspectives from Key Informant Interviews
Policy Brief
University of Minnesota Rural Health Research Center
Date: 03/2024
This policy brief describes findings from interviews with key informants from intimate partner violence (IPV) victim support and advocacy organizations, shedding light on distinct challenges faced by rural victims and survivors. It also highlights targeted opportunities for better supporting the health and safety of rural IPV victims and survivors.
Racial/Ethnic Differences in Experiences of Intimate Partner Violence and Postpartum Abuse Screening Among Rural U.S. Residents Who Gave Birth 2016-2020
Policy Brief
University of Minnesota Rural Health Research Center
Date: 03/2024
The goal of this analysis is to describe intimate partner violence among rural U.S. residents who gave birth 2016-2020, with a focus on differences by race/ethnicity. Researchers also describe the frequency by which different racial/ethnic groups are not screened for abuse postpartum.

2023

Eight Postpartum Support Programs in Rural Communities Across the United States
University of Minnesota Rural Health Research Center
Date: 08/2023
This case study series highlights locally focused organizations working to improve postpartum health for rural residents across the United States. Interviews were conducted with eight unique organizations working in their local rural communities to support postpartum health.
Rural/Urban Differences in Rates and Predictors of Intimate Partner Violence and Abuse Screening Among Pregnant and Postpartum United States Residents
Journal Article
University of Minnesota Rural Health Research Center
Date: 08/2023
This paper uses the 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS) data to describe rates and predictors of perinatal intimate partner violence (IPV) and rates and predictors of not being screened for abuse among rural and urban IPV victims who gave birth.
State Differences in Recommended Components of Care Received During Postpartum Visits for Rural and Urban Residents, 2016-2019
Policy Brief
University of Minnesota Rural Health Research Center
Date: 07/2023
The purpose of this policy brief is to measure state-level differences in the receipt of recommended postpartum care components among rural and urban residents in the United States who gave birth from 2016 to 2019.
Two National-Level Organizations Supporting Rural Postpartum Health Across the United States
University of Minnesota Rural Health Research Center
Date: 07/2023
The purpose of this case study series is to highlight national-level organizations working in innovative ways to improve postpartum health for rural residents across the United States. These may serve as examples to others considering this work.
Maniilaq Health Center: Providing High-Quality Obstetric Care to American Indian/Alaska Native People in Rural Kotzebue, Alaska
University of Minnesota Rural Health Research Center
Date: 06/2023
This case study highlights a hospital providing care to rural American Indian and Alaska Native patients within the state of Alaska. The study examines the maternity care context with attention to the intersection of race and geography with social determinants of health.
Understanding and Overcoming Barriers to Rural Training in Family Medicine Obstetrics Fellowships
Policy Brief
WWAMI Rural Health Research Center
Date: 06/2023
This policy brief describes the results of a survey on the characteristics and challenges faced by rurally oriented family medicine obstetrics fellowship programs. All survey respondents reported their programs had a mission to train family physicians for rural practice, yet less than one-third of programs reported they required rural training.
Rural and Urban Differences in Insurance Coverage at Prepregnancy, Birth, and Postpartum
Journal Article
University of Minnesota Rural Health Research Center
Date: 03/2023
In this manuscript, the research team used data from the Pregnancy Risk Assessment Monitoring System to measure insurance coverage at prepregnancy, birth, and postpartum, and insurance coverage continuity across these periods among rural and urban U.S. residents.
Understanding and Overcoming Barriers to Rural Obstetric Training for Family Physicians
Journal Article
WWAMI Rural Health Research Center
Date: 03/2023
Family physicians are the most common health professional providing rural obstetric (OB) care, but the number of family physicians practicing OB is declining. This mixed-methods study aimed to inform policy and practice solutions to address the training landscape and inform sustainable initiatives for rural family medicine obstetrical training.

2022

A Comparison of Evidence-Based Supports for Maternal and Infant Health in 133 Rural U.S. Counties With and Without Hospital-Based Obstetric Care
University of Minnesota Rural Health Research Center
Date: 12/2022
This infographic offers a comparative look at evidence-based supports available for maternal and infant health in rural counties with recently closed obstetric units (within the past 10 years) and those with hospital-based obstetric care at the time of the survey, in 2021.
Association of Health Insurance, Geography, and Race and Ethnicity With Disparities in Receipt of Recommended Postpartum Care in the U.S.
Journal Article
University of Minnesota Rural Health Research Center
Date: 10/2022
This study used data from the Pregnancy Risk Assessment Monitoring System and looked at receipt of recommended postpartum care content. The study describes variations across health insurance type, rural or urban residence, and race and ethnicity.
Racial/Ethnic Disparities in Postpartum Health Insurance Coverage Among Rural and Urban U.S. Residents
Journal Article
University of Minnesota Rural Health Research Center
Date: 09/2022
Using data from the 2016-2019 Pregnancy Risk Assessment Monitoring System, this study describes postpartum health insurance coverage for rural and urban U.S. residents who are Black, Indigenous, and people of color (BIPOC) compared to those who are white.
Providing High-Quality Support to Pregnant People and Their Families in Racially Diverse Rural Communities
University of Minnesota Rural Health Research Center
Date: 08/2022
The purpose of this case series is to highlight examples from racially diverse rural communities, where hospitals and health systems with obstetric units strive to meet patient needs and provide evidence-based, supportive services during pregnancy, childbirth, and the postpartum period.
County-Level Availability of Obstetric Care and Economic Implications of Hospital Closures on Obstetric Care
Policy Brief
Center for Economic Analysis of Rural Health
Date: 07/2022
This policy brief draws out demographic and economic differences between counties with obstetric care facilities and those without. It provides descriptive data on the economic changes underway in counties that lost obstetric care facilities between 2012 and 2019.
Inequities in Availability of Evidence-Based Birth Supports to Improve Perinatal Health for Socially Vulnerable Rural Residents
Journal Article
University of Minnesota Rural Health Research Center
Date: 07/2022
This study aimed to understand the availability of evidence-based supports and services that promote maternal and infant health, in the rural U.S. The study developed a national survey of a sample of rural hospitals and determined the county-level scores on the 2018 CDC Social Vulnerability Index for each responding hospital.
Racial Inequities in the Availability of Evidence-Based Supports for Maternal and Infant Health in 93 Rural U.S. Counties With Hospital-Based Obstetric Care
Policy Brief
University of Minnesota Rural Health Research Center
Date: 07/2022
This policy brief examines racial disparities in rural maternal and infant health outcomes between majority-Black, Indigenous, and People of Color versus majority-white rural counties and examines the availability of maternal and infant health evidence-based supports.
Rural Hospital Administrators' Beliefs About Safety, Financial Viability, and Community Need for Offering Obstetric Care
Journal Article
University of Minnesota Rural Health Research Center
Date: 03/2022
This study offers results from a national survey of a sample of 292 rural hospitals that provided obstetric services in 2021. Obstetric unit administrators shared about their experiences, the challenges they face, and the decisions that factor into providing labor and birth care for their rural communities.
Disparities in Prenatal Immunization Rates in Rural and Urban U.S. Areas by Indicators of Access to Care
Journal Article
Southwest Rural Health Research Center
Date: 02/2022
This study evaluates variations in immunization rates among pregnant women across the urban-rural continuum. Results indicate pregnant women in rural areas more commonly rely on Medicaid to fund prenatal care but are less likely to have full or expanded access to Medicaid. This finding may contribute to immunization uptake disparities.
An Enhanced Method for Identifying Hospital-Based Obstetric Unit Status
University of Minnesota Rural Health Research Center
Date: 01/2022
The purpose of this methodology brief is to describe an enhanced method for identifying hospital-based obstetric unit status and for identifying closures of obstetric units.

2021

State and Regional Differences in Access to Hospital-Based Obstetric Services for Rural Residents, 2018
Policy Brief
University of Minnesota Rural Health Research Center
Date: 08/2021
This policy brief measures state and regional differences in the availability of hospital-based obstetric services among rural hospitals in the U.S. in 2018.
Disparities in Maternal Immunization Among Women Residing in Rural and Urban Areas of the United States
Journal Article
Southwest Rural Health Research Center
Date: 06/2021
This study evaluates disparities in urban-rural influenza vaccination rates of women prior to and during pregnancy using 2016-2018 Pregnant Risk Assessment Monitoring System data. Findings indicate women residing in rural areas have lower vaccination rates with the greatest differences seen in Hispanic women and women with no health insurance.
Characteristics of Rural and Urban U.S. Hospitals Based on Obstetric Services
University of Minnesota Rural Health Research Center
Date: 04/2021
This infographic provides an overview of characteristics of rural and urban hospitals in the United States that provide obstetric services, as well as rural hospitals that recently closed their obstetric units.
Rural and Urban Hospital Characteristics by Obstetric Service Provision Status, 2010-2018
Policy Brief
University of Minnesota Rural Health Research Center
Date: 04/2021
The purpose of this policy brief is to illustrate the differences between urban and rural hospitals that provide obstetric services by their size, capacity, location, and community characteristics, as well as to compare these factors between rural hospitals with obstetric services and those that recently closed their obstetric units.
Trends in Singleton Preterm Births by Rural Status in the U.S., 2012-2018
Policy Brief
Southwest Rural Health Research Center
Date: 04/2021
This brief examines singleton preterm birth rates by rurality and across census regions in the U.S. It also studies the relationship between singleton preterm birth and several maternal characteristics among women who lived in counties with various rurality levels from 2012-2018.
Rural-Urban Residence and Maternal Hepatitis C Infection, U.S.: 2010-2018
Journal Article
Maine Rural Health Research Center
Date: 02/2021
This study uses data from the U.S. natality files to examine rural-urban differences in county-level rates of maternal infection with hepatitis C virus (HCV) during 2010-2018. Findings can help inform implementation of community-level interventions to reduce maternal HCV infection and narrow rural-urban disparities.

2020

Emergency Obstetric Training Needed in Rural Hospitals Without Obstetric Units
Policy Brief
University of Minnesota Rural Health Research Center
Date: 11/2020
This policy brief discusses the types of training identified by respondents and how those trainings may or may not meet the needs of those managing emergency obstetric situations in rural communities.
Local Capacity for Emergency Births in Rural Hospitals Without Obstetrics Services
Journal Article
University of Minnesota Rural Health Research Center
Date: 11/2020
As increasing numbers of rural hospitals stop offering maternity care, limited information is available about local preparedness to address obstetric emergencies. This paper explores the capacity to treat obstetric emergencies encountered among rural hospitals without obstetric units.
Making It Work: Models of Success in Rural Maternity Care
University of Minnesota Rural Health Research Center
Date: 11/2020
The goal of this case series is to describe key factors that underlie three successful models of rural maternity care and to inform communities, clinicians, and hospitals that wish to keep obstetric services available locally.
Obstetric Emergencies in Rural Hospitals: Challenges and Opportunities
Policy Brief
University of Minnesota Rural Health Research Center
Date: 09/2020
The purpose of this policy brief is to describe the challenges rural hospitals face in providing emergency obstetric care and to highlight resources that could help rural hospitals more safely respond to obstetric emergencies.
Characteristics of U.S. Rural Hospitals by Obstetric Service Availability, 2017
Journal Article
University of Minnesota Rural Health Research Center
Date: 08/2020
This study described characteristics of rural U.S. hospitals by whether they provide labor and delivery care for pregnant patients. Researchers used the 2017 American Hospital Association Annual Survey to identify rural hospitals and detail their characteristics based on whether they provide obstetric services.
Providing Maternity Care in a Rural Northern Iowa Community
University of Minnesota Rural Health Research Center
Date: 08/2020
This case study highlights how one rural hospital in northern Iowa has successfully sustained a maternity care practice and identifies opportunities for other rural hospitals and communities seeking to ensure local access to care for pregnancy and childbirth.
Changes in Hospital-Based Obstetric Services in Rural U.S. Counties, 2014-2018
Journal Article
University of Minnesota Rural Health Research Center
Date: 07/2020
In 2014, 54% of rural U.S. counties had no hospital-based obstetric services, following a steady decrease during the previous decade. Loss of rural maternity care is tied to adverse maternal and infant health outcomes. This study shares hospital-based obstetric service losses in rural U.S. counties from 2014 to 2018.
Loss of Hospital-Based Obstetric Services in Rural Counties in the United States, 2004-2018
University of Minnesota Rural Health Research Center
Date: 07/2020
The purpose of this infographic is to show the loss of hospital-based obstetric services from 2004-2018 and how this differs by county type (micropolitan vs. noncore).
The Supply and Rural-Urban Distribution of the Obstetrical Care Workforce in the U.S.
Policy Brief
WWAMI Rural Health Research Center
Date: 06/2020
Monitoring the supply of the obstetrical (OB) care workforce is important for identifying areas that may lack OB care access. This brief describes the supply and geographic distribution of obstetricians, advanced practice midwives, midwives (not advanced practice), and family physicians in rural versus urban counties.
The Supply and Rural-Urban Distribution of the Obstetrical Care Workforce in the U.S. - A State-Level Analysis
Report
WWAMI Rural Health Research Center
Date: 06/2020
Monitoring the supply of the obstetrical (OB) care workforce is important for identifying areas that may lack OB care access. This set of data briefs describes the supply and geographic distribution of obstetricians, advanced practice midwives, midwives (not advanced practice), and family physicians in rural versus urban counties for every state.
Are Rural Infants Benefiting From Woman, Infants, and Children (WIC) Food Package Rule Changes? Breastfeeding and Infant Feeding Behaviors
Policy Brief
Southwest Rural Health Research Center
Date: 02/2020
This study compared breastfeeding initiation for rural and urban Women, Infants, and Children (WIC) participants before and after the changes in WIC Food Packages (WIC-FPs). In addition, changes in breastfeeding and infant feeding practices before and after changes in WIC program benefits were explored.

2019

Rural-Urban Differences in Severe Maternal Morbidity and Mortality in the U.S., 2007-15
Journal Article
University of Minnesota Rural Health Research Center
Date: 12/2019
In the U.S., severe maternal morbidity and mortality (SMMM) is climbing—a reality that is especially challenging for rural communities, which face declining access to obstetric services. Using data for 2007-15 from the National Inpatient Sample, we analyzed SMMM during childbirth hospitalizations among rural and urban residents.
Severe Maternal Morbidity and Hospital Transfer Among Rural Residents
Policy Brief
University of Minnesota Rural Health Research Center
Date: 11/2019
In this brief, we compare hospital transfer rates for rural and urban residents who gave birth. We also provide descriptive information about the relationship between transfer status and severe maternal morbidity and mortality for rural residents nationally who gave birth 2008-2014.
Rural Focus and Representation in State Maternal Mortality Review Committees: Review of Policy and Legislation
Journal Article
University of Minnesota Rural Health Research Center
Date: 08/2019
Between 1990 and 2013, maternal mortality nearly doubled in the U.S., and rural residents experienced decreasing access to obstetric care. To improve maternal health, many states have established maternal mortality and morbidity review committees (MMRCs). We assessed the extent of rural representation in state policy efforts related to MMRCs.

2018

Practical Implications: Opioid-Affected Births to Rural Residents
Policy Brief
University of Minnesota Rural Health Research Center
Date: 09/2018
This publication provides two physicians' reactions to research findings on rates of diagnosis of maternal opioid use disorder and infant neonatal abstinence syndrome at the time of childbirth for rural residents based on the type of hospital where the birth occurred.
Non-Medical Opioid Use Among Rural and Urban Pregnant Women, 2007-2014
Policy Brief
University of Minnesota Rural Health Research Center
Date: 08/2018
This policy brief presents data on rural-urban differences in non-medical opioid use among pregnant women to inform policy, programmatic, and clinical efforts to address this crisis.
Association Between Loss of Hospital-Based Obstetric Services and Birth Outcomes in Rural Counties in the United States
Journal Article
University of Minnesota Rural Health Research Center
Date: 03/2018
This study examines whether the loss of obstetric services in hospitals in rural U.S. counties led to changes in childbirth outcomes or locations.
Challenges Related to Pregnancy and Returning to Work After Childbirth in a Rural, Tourism-Dependent Community
University of Minnesota Rural Health Research Center
Date: 02/2018
This case study highlights challenges related to pregnancy and returning to work after childbirth in a rural, tourism-dependent community in Minnesota.

2017

Access to Obstetric Services in Rural Counties Still Declining, With 9 Percent Losing Services, 2004-14
Journal Article
University of Minnesota Rural Health Research Center
Date: 09/2017
Providing access to obstetric care in rural areas is a growing concern. By 2014, about 54% of rural counties in the United States did not have hospital obstetric services.
The Maternity Care Nurse Workforce in Rural U.S. Hospitals
Journal Article
University of Minnesota Rural Health Research Center
Date: 05/2017
Findings are shared from a study examining the maternity care nursing workforce in rural hospital in the United States.
Closure of Hospital Obstetric Services Disproportionately Affects Less-Populated Counties
Policy Brief
University of Minnesota Rural Health Research Center
Date: 04/2017
This policy brief describes the scope of obstetric unit and hospital closures resulting in loss of obstetric services in rural U.S. counties from 2004 to 2014.
State Variability in Access to Hospital-Based Obstetric Services in Rural U.S. Counties
Policy Brief
University of Minnesota Rural Health Research Center
Date: 04/2017
This policy brief describes state-level variations in 1) the availability of hospital-based obstetric services, and 2) the scope of obstetric unit and hospital closures resulting in the loss of obstetric services in rural U.S. counties from 2004 to 2014.
Rural Hospital Employment of Physicians and Use of Cesareans and Nonindicated Labor Induction
Journal Article
University of Minnesota Rural Health Research Center
Date: 03/2017
Findings are shared from a study that discovered the types of doctors employed at rural hospitals may make a difference in the rates of cesarean births.

2016

Relationship Between Hospital Policies for Labor Induction and Cesarean Delivery and Perinatal Care Quality Among Rural U.S. Hospitals
Journal Article
University of Minnesota Rural Health Research Center
Date: 11/2016
This study focused on maternity care quality by taking a look at hospitals' policies regarding induced labor and Cesarean deliveries.
Why Are Obstetric Units in Rural Hospitals Closing Their Doors?
Journal Article
University of Minnesota Rural Health Research Center
Date: 08/2016
Analyzes the reasons behind hospital- and county-level factors for rural obstetric unit closures.
Factors Associated With High-Risk Rural Women Giving Birth in Non-NICU Hospital Settings
Journal Article
University of Minnesota Rural Health Research Center
Date: 07/2016
Identifies rick factors for childbirth in facilities without neonatal intensive care unit (NICU) capacities among high-risk rural women. The study found that rural women with preterm birthday and multiple gestation pregnancies were less likely to give birth in a hospital with NICU capacity if no local hospital had this capacity.
The Practice of Midwifery in Rural U.S. Hospitals
Journal Article
University of Minnesota Rural Health Research Center
Date: 07/2016
Analyzes the role of certified nurse-midwives (CNMs) in providing maternity care in rural US hospitals and to examine state-level variations on rural CNM practice. CNMs play an important role in the maternity care workforce in rural US hospitals.
Ensuring Access to High-Quality Maternity Care in Rural America
Journal Article
University of Minnesota Rural Health Research Center
Date: 05/2016
Examines the access to high-quality for rural women care during pregnancy and childbirth. Policy interventions at the local, state, and federal levels could help to address maternity care workforce shortages and improve quality of care available to the one-half million rural U.S. women who give birth each year.
Location of Childbirth for Rural Women: Implications for Maternal Levels of Care
Journal Article
University of Minnesota Rural Health Research Center
Date: 05/2016
This study looks into the rate at which rural women give birth at nonlocal hospitals. Approximately 75% of rural women gave birth at local hospitals. However, after controlling for clinical complications, rural Medicaid beneficiaries were less likely to give birth at nonlocal hospitals, implying a potential access challenge for this population.
Rural Implications of Expanded Birth Volume Threshold for Reporting Perinatal Care Measures
Journal Article
University of Minnesota Rural Health Research Center
Date: 04/2016
In 2016 the minimum annual birth volume threshold for required reporting of the Joint Commission Perinatal Care measures by accredited hospitals decreased from 1,100 to 300 births. This study used the publicly available Join Commission Quality Check data from April 2014 to March 2015.
Variation in Primary Care Service Patterns by Rural-Urban Location
Journal Article
RUPRI Center for Rural Health Policy Analysis
Date: 03/2016
Examines primary care physician service patterns by rural-urban location and discusses effect on recruitment strategies for primary care providers in rural communities.

2015

Rural Women Delivering Babies in Non-Local Hospitals: Differences by Rurality and Insurance Status
Policy Brief
University of Minnesota Rural Health Research Center
Date: 06/2015
This policy brief describes the extent to which rural pregnant women give birth in non-local hospitals and analyzes current patterns of non-local delivery by rural women's health insurance status and residential rurality.
The Rural Obstetric Workforce in U.S. Hospitals: Challenges and Opportunities
Journal Article
University of Minnesota Rural Health Research Center
Date: 03/2015
Describes the healthcare and clinician types who are delivering babies in rural hospitals, such as family physicians, general surgeons, obstetricians, and midwives. Discusses the relationship between hospital birth volume and staffing models.

2014

The Obstetric Care Workforce in Critical Access Hospitals (CAHs) and Rural Non-CAHs
Policy Brief
University of Minnesota Rural Health Research Center
Date: 11/2014
This brief details rural hospital obstetric staffing patterns in nine states by critical access hospital status. The purpose was to examine obstetric practice models in rural hospitals, providing information to rural hospitals with obstetric care units regarding workforce and informing policymakers about the context in which the hospitals operate.
Rural-Urban Differences in Obstetric Care 2002-2010 and Implications for the Future
Journal Article
University of Minnesota Rural Health Research Center
Date: 01/2014
Measures obstetric care in both rural and urban hospitals to find if trends differ from rural and urban hospital locations.
Birth Volume and the Quality of Care in Rural Hospitals
Journal Article
University of Minnesota Rural Health Research Center
Date: 2014
Evaluates obstetric care quality in low-, medium-, and high-volume areas by using hospital discharge data.

2013

Obstetric Services and Quality Among Critical Access, Rural, and Urban Hospitals in Nine States
University of Minnesota Rural Health Research Center
Date: 06/2013
This policy brief compares the characteristics and quality of obstetric care in critical access hospitals, other rural hospitals, and their urban counterparts.
Rural Population Estimates: An Analysis of a Large Secondary Data Set
Journal Article
Rural and Minority Health Research Center
Date: 2013
Examines in the underrepresentation of rural counties in large secondary data sources, specifically the Behavioral Risk Factor Surveillance System (BRFSS).

2008

National Trends in the Perinatal and Infant Health of Rural American Indians (AIs) and Alaska Natives (ANs): Have the Disparities Between AI/ANs and Whites Narrowed?
Policy Brief
WWAMI Rural Health Research Center
Date: 06/2008
This policy brief provides an overview of findings from a study examining trends in prenatal care receipt, low-birthweight rates, neonatal and postneonatal death rates, and cause of death among rural American Indians/Alaska Natives and whites between 1985 and 1997.
Poor Birth Outcome in the Rural United States: 1985-1987 to 1995-1997 (Final Report)
WWAMI Rural Health Research Center
Date: 02/2008
Rates of low birthweight, poor outcomes, and inadequate prenatal care among urban and rural areas were evaluated and compared from 1985-1997 using data from the Linked Birth-Death Data Set.
Poor Birth Outcome in the Rural United States: 1985-1987 to 1995-1997 (Project Summary)
WWAMI Rural Health Research Center
Date: 02/2008
Rates of low birthweight, poor outcomes, and inadequate prenatal care among urban and rural areas were evaluated and compared from 1985-1997 using data from the Linked Birth-Death Data Set.

2007

Why Are Fewer Hospitals in the Delivery Business?
NORC Walsh Center for Rural Health Analysis
Date: 04/2007
This study examines the declining availability of hospital-based obstetric services in rural areas from the mid-1980s to the early 2000s. It looks at potential causes for this trend and explores the effects of medical malpractice reforms.

2006

Racial and Ethnic Disparities in Potentially Avoidable Delivery Complications Among Pregnant Medicaid Beneficiaries in South Carolina
Journal Article
Rural and Minority Health Research Center
Date: 2006
Within groups defined by race or ethnicity, unadjusted rates for potentially avoidable maternity complications did not differ significantly by hospital location. Potentially avoidable maternity complications in rural hospitals, African Americans had higher risk for complications than did non-Hispanic whites.

2005

Cesarean Section Rates in Rural Hospitals
North Carolina Rural Health Research and Policy Analysis Center
Date: 03/2005
This findings brief examines childbirth delivery patterns in rural hospitals and compares the C-section rate in rural hospitals to that in urban hospitals using the Nationwide Inpatient Sample.
Delivery Complications Associated With Prenatal Care Access for Medicaid-Insured Mothers in Rural and Urban Hospitals
Journal Article
Rural and Minority Health Research Center
Date: 2005
Examined access to healthcare during pregnancy for mothers insured by Medicaid as well as the risks of potentially avoidable maternity complications among rural and urban hospital deliveries for groups of mothers defined by race or ethnicity.

2004

Impact of Medicaid Managed Care, Race/Ethnicity, and Rural/Urban Residence on Potentially Avoidable Maternity Complications: A Five-State Multi-Level Analysis
Rural and Minority Health Research Center
Date: 12/2004
This study examines pregnancy-related complications using Potentially Avoidable Maternity Complications as an indicator of access.
Cesarean Section Patterns in Rural Hospitals
North Carolina Rural Health Research and Policy Analysis Center
Date: 11/2004
This paper examines childbirth delivery patterns in rural hospitals and compares the cesarean section rate in rural hospitals to that in urban hospitals.
Development of a Methodology for Assessing the Effect of a Lay Home Visitation Program for Rural High-Risk Women and Infants
Rural and Minority Health Research Center
Date: 02/2004
This pilot study successfully demonstrated that a retrospective, population-based, comparative design is a feasible method for evaluating the effectiveness of a community health worker program for women at risk for poor pregnancy and birth outcomes.
Assessing the Effect of a Lay Home Visitation Program for Rural High-Risk Women and Infants
Rural and Minority Health Research Center
Date: 2004
This study tested a retrospective data set approach for evaluating the effectiveness of a community health worker program to improve pregnancy and birth outcomes. The program uses lay health workers to provide health education, referral, and social support to rural, low income, Medicaid-insured pregnant African-American women and their infants.
Effects of Medicaid Managed Care and Medicaid Managed Care Penetration on Potentially Avoidable Maternity Complications
Fact Sheet
Rural and Minority Health Research Center
Date: 2004
The effects of Medicaid Managed Care on pregnancy-related complications affecting mothers during their delivery hospitalizations were examined using the Potentially Avoidable Maternity Complications indicator.

2002

Perinatal and Infant Health Among Rural and Urban American Indians/Alaska Natives
Journal Article
WWAMI Rural Health Research Center
Date: 09/2002
Provides a national profile of rural and urban American Indian/Alaska Native (AI/AN) maternal and infant health.

1997

Access to Maternity Care in Rural Washington: Its Effect on Neonatal Outcomes and Resource Use
Journal Article
Upper Midwest Rural Health Research Center
Date: 01/1997
Compares birth outcomes for areas with poor healthcare access to those with adequate healthcare access in rural Washington state.