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Maternal health care is disappearing in rural communities

BIRMINGHAM, Ala. (WBRC) – Maternal health care is disappearing in rural parts of the country, including right here in Alabama—making it tougher for people to get the care they need to deliver healthy babies.

According to the American Hospital Association, nearly half of rural hospitals across the U.S. don’t offer labor and delivery services, leaving expectant mothers in maternity care deserts.

“34 or our 55 rural counties, we don’t have delivery services.”

President of the Alabama Hospital Association, Dr. Don Williamson, said there are several reasons why maternal health care is vanishing, especially in rural communities.

“You’ve got difficulty recruiting physicians in the rural areas, you’ve got a significant financial challenge of delivering, and liability has certainly been a problem as well. It’s not surprising that in significant parts of rural Alabama we don’t have delivery services in those counties,” Dr. Williamson explained.

It also takes a lot of money to run and maintain labor and delivery units.

Rural communities have smaller populations, so there are fewer births making the system unsustainable.

“The real challenge is for uninsured moms, and I think it’s no surprise that individuals who are uninsured tend to end up getting less prenatal care or getting it later, and that contributes to an outcome, both for moms and babies, that’s certainly less desirable,” Dr. Williamson said.

According to the American Hospital Association, about 12 million women aged 15 to 54 live in rural areas, and more than 2.2 million of them live in maternity care deserts.

That means traveling long distances for delivery and prenatal care—a journey many can’t afford to make.

“How do low-income women who don’t qualify for Medicaid who are uninsured, how do they get health care, and all too often they get limited to no prenatal care, and often their first visit can be in the ER, and while they will get high-quality care and delivery with their child, the ER is not the first time you want to get prenatal care,” Dr. Williamson said.

Dr. Williamson said expanding Medicaid is one possible solution for improving the overall health of women aged 19 to 64, as well as improving outcomes for expectant mothers in Alabama.


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