Postpartum Morbidity and Mortality and Health Care Utilization in Rural vs. Urban Communities

Maternal deaths have increased 40% in the last decade, and half of all maternal deaths occur in the year following birth. Almost 60% of maternal deaths are due to obstetric-related causes while more than one in five deaths are drug-related or due to suicide or homicide. Further, disparities in the rate of maternal death and the causes of death exist by rurality. Limited access to care in the postpartum period is frequently cited as a top contributor to these maternal deaths. Rural communities continue to experience hospital and obstetric unit closures, with only 40% of rural counties having hospital-based obstetric units as of 2018. As a result, rural pregnant patients have to travel farther for care and have less frequent prenatal care prior to delivery as well as reduced access to care after childbirth.

Understanding the health needs and access challenges that rural postpartum patients face is essential for improving postpartum health and for reducing postpartum maternal deaths in rural communities. Using 2006-2018 data from the National Health Interview Survey linked to the National Death Index through 2019, this project examined postpartum mortality among rural and urban residents. It also evaluated differences in health, health care utilization, and barriers to care across rural and urban communities, assessing the interaction of rurality and insurance status.

Publications

• Rural/Urban Differences in Health, Health Care Use, and Barriers to Care for Postpartum and Parenting Women, 2006-2018
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 08/2025
  The goal of this analysis was to describe rural/urban differences in health, health care utilization, and barriers to care for reproductive-age females, with specific focus on those who are parents of young children (ages 1-4) and those who are postpartum (gave birth in the last year).