By Laura Robertson
The night I was born, my parents almost didn’t go to the hospital. My father didn’t believe my mother when she woke up in the middle of the night, insisting she was going into labor. My mom was almost forty when she had me, making her pregnancy automatically high-risk. Luckily for her, it took me long enough to get my act together and be born that she was able to successfully convince my dad, drive to the local small-town hospital, and have me. I was born 1.2 miles from the house I would spend the next six years of my life in, under the care of the same ob/gyn who had been with my mother throughout her pregnancy.
Had I been born today, it is likely my first breaths would have taken place on the side of the road, in a mad dash to get to the nearest maternity ward, 40 minutes away by car. The ward that I was born in has closed, leaving behind a “maternity desert,” that leaves expectant mothers scrambling for medical care. Today, 45% of rural counties lack a licensed ob/gyn, and according to statistics from the Wall Street Journal, rural mothers are 60% more likely to die in childbirth than their urban and suburban counterparts. Rural mothers are less likely to have their children in hospitals, and less likely to get preventative prenatal care throughout their pregnancy. For many, it is simply not feasible to attend regular appointments that are, as is the case for more than 10% of this demographic, more than 100 miles away. Of course, the very possibility of having the option relies on the premise that one has access to a car; public transportation is rare in rural areas, and ambulance services are only available if a pregnancy becomes life-threatening. Even if they are offered, geography can postpone their arrival long enough that they are rendered useless anyway.
These statistics exist for a variety of reasons. Firstly, rural hospitals tend to be small, allowing them to keep far fewer specialists than their more urban equivalents. Many hospitals rely on family practice physicians to perform obstetric services, and even those who can afford to keep a licensed ob/gyn around might not be able to house the specialists who can perform certain kinds of life-saving surgeries that would lessen the mortality rate. Conversely, even those hospitals who can afford to keep these specialists around often struggle to do so– there are almost 8,000 too few ob/gyns nationwide, and only 6% of these work in rural areas. This is compared to the 22% of Americans of childbearing age that live in these regions. As the urban/rural divide deepens, cultural mistrust seeming to grow every day, rural issues can often be forgotten about. After all, they are by definition distant from the city centers in which much of our legislation is decided. As many rural Americans are politically conservative, favoring small, localized government over anything that seems to extend its hand too far into the lives of the individual, rural issues are rarely hot-button topics in the national political scene. For many, limited medical care is a necessary consequence of the stronger sense of community and freedom that they feel their areas give them.
While government legislation may not be the solution—and likely wouldn’t be appreciated by much of the demographic it would intend to serve—new conversations around these issues have led to attempts to find a solution that would work. In the last few years have maternity deserts have begun to find coverage in national news, while The University of Wisconsin School of Medicine and Public Health has set up the nation’s first—and only—residency program that specifically focuses on women’s health in rural areas. Steps like these, while still falling short of annihilating the issue, suggest the possibility of a safer future for rural women.