Improving Racial Equity for Rural Mothers and Infants

Research center:
Lead researcher:
Project funded:
September 2021
Project completed:
December 2023

The health of rural families is of growing concern across the U.S. because maternal and infant morbidity and mortality are higher for rural residents, compared to urban residents, and access to care during pregnancy and childbirth is declining in rural communities. Both poor outcomes and lack of access may be related to limited access to evidenced-based maternity care and support programs for pregnant people and their families in rural communities.

Not all rural communities are equally affected; our Center's prior research has shown that rural US counties with a majority Black or Indigenous population have higher rates of premature death. Our data also highlight the particular vulnerability of rural residents and Black and Indigenous people to poor maternal health outcomes. Addressing the intersection of racial and geographic equity in maternity care is therefore an essential step toward addressing the national maternal health crisis. In this project, we compared maternal and infant health outcomes between rural and urban counties and assessed the availability of evidence-based maternity care services and supports, both by geography and by the racial demographics of counties. We conducted case studies in racially diverse rural communities. We explored potential policy options to increase equitable access to evidence-based care during pregnancy and childbirth that may improves outcomes for birthing people and infants across the life course. Pregnancy and childbirth have been identified as a critical juncture in the life course, with the potential to alter the future trajectory for health outcomes and to improve health equity.