Trying to have a baby in flyover country

[RiskManager]

Maternal Health Care Is Disappearing in Rural America - Scientific American

It is getting more and more difficult to find a provider to deliver your baby and a hospital to do it in. Lots of reasons for this: OB is a money-loser for hospitals, lack of reimbursement, difficulty in finding L&D staffing and the typical provider does not want to live out in the sticks.

[LibraSunCNM, BSN, MSN, CNM]

Interesting that they focus on Alabama, which is possibly the most midwife-UNfriendly state in the U.S., lament the lack of providers there, and then only mention with one sentence that increasing the number of CNMs in AL could help the problem. Ya think?

[HouTx, BSN, MSN, EdD]

Interesting article. I was also dismayed about the very brief mention of CNM contribution to quality OB care.... just a couple of sentences. It would have been a much better piece if the author had reached out to a qualified CNM representative for some balanced input.

I've had the privilege of working with rural hospitals for quite a while. Like many other Western states, we differentiate "rural" into subcategories. Countryside rural (non metro) & Frontier rural (

IMO, the bigger issue is sustaining access to qualified maternal services - we have some large counties without ANY physician or health care services. The existence of many rural health clinics and critical access facilities is only possible because the highly flexible and adaptable staff - but they can't function without physicians or mid-levels. Those 'doing public service to work off my med school debt' docs dash back to urban areas as quickly as their obligation ends. Without some sort of funding stream to provide qualified locums to relieve those essential sole providers & a way to guarantee them a competitive income it's just about impossible to sustain a medical practice in very rural areas. Is the urban population willing to subsidize rural care? If not, what are the alternatives? THAT's an issue that needs to be addressed.

[RiskManager]

^^^Another factor contributing to provider recruitment and retention in rural areas is a job for the spouse/significant other. The provider can find a job easily enough, but if the spouse/significant other cannot find a job in their field, that is a strike against the provider taking the job.

[Amethya]

My CMA teacher lived in the sticks when she got into MA school. Because I guess it a long time ago, they really didn't care who took care of who, so she would do what nurses did at hospitals because of lack of nursing staff.