Higher-Level Maternity Care Access in Rural Communities

This project will explore measurement of higher-level maternal care, and – where feasible – comprehensively describe access to childbirth-related care for families living in rural communities, with a focus on higher-level care for pregnant patients and infants with acute clinical needs. This project will also describe the types of hospitals where data on higher-level maternity care are not available or may not be accurate, so that future data support efforts can target these rural hospitals. Understanding the availability of higher-level maternal and neonatal care is necessary for ensuring access to risk-appropriate care for rural maternal-infant dyads. While models for secondary data-based measures do exist, there is no validated measure of hospital maternal levels of care currently available. As a result, a key part of this project is assessing whether higher-level maternal care can be accurately measured with available secondary data sources. Additionally, for hospitals where maternal levels of care can be accurately assessed, this project will recognize the factors that predict whether a hospital has discordant levels of care for pregnant patients and infants. These data can help inform clinical and policy efforts to ensure availability and access to essential, life-saving, and risk-appropriate care for the maternal- infant dyad at the time of childbirth.