Maternal and Infant Care in Rural Missouri: Challenges and Solutions
Published Nov 21, 2024
Maternal and infant care is a crucial aspect of public health, but patients living in rural areas often face unique challenges that can hinder access to quality health care. Understanding these obstacles is essential for improving care and outcomes for mothers and their babies.
Challenges for Patients in Rural Areas
Economic Factors
Higher poverty rates in rural communities significantly impact access to health care services. Many families struggle to afford necessary medical care, leading to delays in seeking treatment and a lack of prenatal and postnatal care.
Transportation Barriers
Inadequate transportation options pose a significant challenge for many rural patients. Long distances to health care facilities can make it difficult for mothers to attend regular checkups and appointments, ultimately affecting their health and that of their infants.
Limited Educational Resources
Access to information about maternal and infant health is often scarce in rural areas. This lack of educational resources can result in lower awareness of the importance of prenatal care, leading to missed opportunities for intervention and support.
Social Isolation
Living in rural regions can lead to feelings of isolation, particularly for new mothers. This social isolation may impact mental health and limit the support systems that are critical for new parents.
Stigma
Many women in rural areas face stigma regarding their struggles with substance use during pregnancy. Fears about being judged or having their baby taken away can prevent them from seeking the help they need.
Challenges for Health Care Providers
Health care providers in rural hospitals and clinics also face distinct challenges when caring for pregnant patients and their infants. Often, OB-GYNs serve as primary care providers, and they may be the first established health care relationship for pregnant patients outside of emergency room visits. Building trust is essential; providers must help patients feel empowered, safe and respected.
Consistency in care and follow-up is vital for establishing security. Involving patients in their own care decisions and respecting their autonomy can foster a more collaborative relationship between providers and patients, leading to better health outcomes.
Resources for Rural Patients
Despite these challenges, there are resources available to assist patients in rural communities. Telehealth services allow patients to consult with health care providers remotely. Both behavioral health and maternal fetal medicine telehealth services are highly utilized by our clinic.
Recognizing that it is difficult for patients to travel out of town for appointments, we collaborated with our MFM providers to develop a telehealth option in our clinic to improve care compliance with our high-risk patients. Prior to this collaboration, MFM appointments had a high no-show rate; after the telehealth implementation, no-show rates are less than 5%.
We also are fortunate to have a care coordinator in our clinic. A dedicated care coordinator can be instrumental in helping patients navigate community resources. They assist with telebehavioral health referrals, provide warm hand-offs to addiction medicine services, and ensure consistent check-ins during routine prenatal and postpartum visits.
How Organizations Can Help
Larger organizations, including hospital systems, managed care organizations, and state governments, have a critical role in improving maternal and infant care in rural areas.
Ongoing Training
Providing continuous education and training for rural health care providers can enhance their ability to deliver effective maternal and infant care.
Awareness Campaigns
Campaigns focused on maternal and infant health issues can increase awareness and encourage more women to seek necessary care.
Advocacy for Policy Support
Advocating for state and federal policies that support maternal and infant health, including Medicaid expansion and coverage awareness, can lead to improved access to care.
Conclusion
Addressing the challenges faced by patients and providers in rural maternal and infant care requires a collaborative effort. By understanding the barriers and leveraging available resources, we can work toward a future where every mother and baby receives the care they deserve, regardless of their geographic location.
About the Author
Tracey Williams, FNP-C, is the Administrative Director of Nursing at Cox Medical Center Branson. For the past nine years, Tracey has worked in both the administrative and nurse practitioner role in caring for pregnant women in rural southwest Missouri. The teams in the Women’s Center and obstetrical department at Cox Medical Center Branson have been involved with Missouri’s PQC projects focused on perinatal mood disorders, substance use disorders and neonatal abstinence syndrome.