Maternal health

Research Products & Journal Articles

Browse the full list of research publications on this topic completed by the Rural Health Research Centers.

Products – Freely accessible products include policy briefs, fact sheets, full reports, chartbooks, and interactive data websites.

Journal Articles – Articles in peer-reviewed journals may require a subscription or affiliation with a subscribing library. For these publications, Gateway lists the article citation, a brief summary, a link to additional information and access to the full-text of the article, if available.

2022

2021

  • State and Regional Differences in Access to Hospital-Based Obstetric Services for Rural Residents, 2018
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 08/2021
    This policy brief measures state and regional differences in the availability of hospital-based obstetric services among rural hospitals in the U.S. in 2018.
  • Characteristics of Rural and Urban U.S. Hospitals Based on Obstetric Services
    University of Minnesota Rural Health Research Center
    Date: 04/2021
    This infographic provides an overview of characteristics of rural and urban hospitals in the United States that provide obstetric services, as well as rural hospitals that recently closed their obstetric units.
  • Rural and Urban Hospital Characteristics by Obstetric Service Provision Status, 2010-2018
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 04/2021
    The purpose of this policy brief is to illustrate the differences between urban and rural hospitals that provide obstetric services by their size, capacity, location, and community characteristics, as well as to compare these factors between rural hospitals with obstetric services and those that recently closed their obstetric units.
  • Trends in Singleton Preterm Births by Rural Status in the U.S., 2012-2018
    Policy Brief
    Southwest Rural Health Research Center
    Date: 04/2021
    This brief examines singleton preterm birth rates by rurality and across census regions in the U.S. It also studies the relationship between singleton preterm birth and several maternal characteristics among women who lived in counties with various rurality levels from 2012-2018.
  • Rural-Urban Residence and Maternal Hepatitis C Infection, U.S.: 2010-2018
    Journal Article
    Maine Rural Health Research Center
    Date: 02/2021
    This study uses data from the U.S. natality files to examine rural-urban differences in county-level rates of maternal infection with hepatitis C virus (HCV) during 2010-2018. Findings can help inform implementation of community-level interventions to reduce maternal HCV infection and narrow rural-urban disparities.

2020

  • Emergency Obstetric Training Needed in Rural Hospitals without Obstetric Units
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 11/2020
    This policy brief discusses the types of training identified by respondents and how those trainings may or may not meet the needs of those managing emergency obstetric situations in rural communities.
  • Local Capacity for Emergency Births in Rural Hospitals Without Obstetrics Services
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 11/2020
    As increasing numbers of rural hospitals stop offering maternity care, limited information is available about local preparedness to address obstetric emergencies. This paper explores the capacity to treat obstetric emergencies encountered among rural hospitals without obstetric units.
  • Making it Work: Models of Success in Rural Maternity Care
    University of Minnesota Rural Health Research Center
    Date: 11/2020
    The goal of this case series is to describe key factors that underlie three successful models of rural maternity care and to inform communities, clinicians, and hospitals that wish to keep obstetric services available locally.
  • Obstetric Emergencies in Rural Hospitals: Challenges and Opportunities
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 09/2020
    The purpose of this policy brief is to describe the challenges rural hospitals face in providing emergency obstetric care and to highlight resources that could help rural hospitals more safely respond to obstetric emergencies.
  • Characteristics of US Rural Hospitals by Obstetric Service Availability, 2017
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 08/2020
    This study described characteristics of rural U.S. hospitals by whether they provide labor and delivery care for pregnant patients. Researchers used the 2017 American Hospital Association Annual Survey to identify rural hospitals and detail their characteristics based on whether they provide obstetric services.
  • Providing Maternity Care in a Rural Northern Iowa Community
    University of Minnesota Rural Health Research Center
    Date: 08/2020
    This case study highlights how one rural hospital in northern Iowa has successfully sustained a maternity care practice and identifies opportunities for other rural hospitals and communities seeking to ensure local access to care for pregnancy and childbirth.
  • Changes in Hospital-Based Obstetric Services in Rural US Counties, 2014-2018
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 07/2020
    In 2014, 54% of rural U.S. counties had no hospital-based obstetric services, following a steady decrease during the previous decade. Loss of rural maternity care is tied to adverse maternal and infant health outcomes. This study shares hospital-based obstetric service losses in rural U.S. counties from 2014 to 2018.
  • Loss of Hospital-based Obstetric Services in Rural Counties in the United States, 2004-2018
    University of Minnesota Rural Health Research Center
    Date: 07/2020
    The purpose of this infographic is to show the loss of hospital-based obstetric services from 2004-2018 and how this differs by county type (micropolitan vs. noncore).
  • The Supply and Rural-Urban Distribution of the Obstetrical Care Workforce in the U.S.
    Policy Brief
    WWAMI Rural Health Research Center
    Date: 06/2020
    Monitoring the supply of the obstetrical (OB) care workforce is important for identifying areas that may lack OB care access. This brief describes the supply and geographic distribution of obstetricians, advanced practice midwives, midwives (not advanced practice), and family physicians in rural versus urban counties.
  • The Supply and Rural-Urban Distribution of the Obstetrical Care Workforce in the U.S. - A State-Level Analysis
    Report
    WWAMI Rural Health Research Center
    Date: 06/2020
    Monitoring the supply of the obstetrical (OB) care workforce is important for identifying areas that may lack OB care access. This set of data briefs describes the supply and geographic distribution of obstetricians, advanced practice midwives, midwives (not advanced practice), and family physicians in rural versus urban counties for every state.
  • Are Rural Infants Benefiting from Woman, Infants, and Children (WIC) Food Package Rule Changes? Breastfeeding and Infant Feeding Behaviors
    Policy Brief
    Southwest Rural Health Research Center
    Date: 02/2020
    This study compared breastfeeding initiation for rural and urban Women, Infants, and Children (WIC) participants before and after the changes in WIC Food Packages (WIC-FPs). In addition, changes in breastfeeding and infant feeding practices before and after changes in WIC program benefits were explored.

2019

  • Rural-Urban Differences In Severe Maternal Morbidity and Mortality In the U.S., 2007-15
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 12/2019
    In the U.S., severe maternal morbidity and mortality (SMMM) is climbing—a reality that is especially challenging for rural communities, which face declining access to obstetric services. Using data for 2007-15 from the National Inpatient Sample, we analyzed SMMM during childbirth hospitalizations among rural and urban residents.
  • Severe Maternal Morbidity and Hospital Transfer Among Rural Residents
    Policy Brief
    University of Minnesota Rural Health Research Center
    Date: 11/2019
    In this brief, we compare hospital transfer rates for rural and urban residents who gave birth. We also provide descriptive information about the relationship between transfer status and severe maternal morbidity and mortality for rural residents nationally who gave birth 2008-2014.
  • Rural Focus and Representation in State Maternal Mortality Review Committees: Review of Policy and Legislation
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 08/2019
    Between 1990 and 2013, maternal mortality nearly doubled in the U.S., and rural residents experienced decreasing access to obstetric care. To improve maternal health, many states have established maternal mortality and morbidity review committees (MMRCs). We assessed the extent of rural representation in state policy efforts related to MMRCs.

2018

2017

2016

  • Relationship Between Hospital Policies for Labor Induction and Cesarean Delivery and Perinatal Care Quality Among Rural U.S. Hospitals
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 11/2016
    This study focused on maternity care quality by taking a look at hospitals' policies regarding induced labor and Cesarean deliveries.
  • Why Are Obstetric Units in Rural Hospitals Closing Their Doors?
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 08/2016
    Analyzes the reasons behind hospital- and county-level factors for rural obstetric unit closures.
  • Factors Associated with High-Risk Rural Women Giving Birth in Non-NICU Hospital Settings
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 07/2016
    Identifies rick factors for childbirth in facilities without neonatal intensive care unit (NICU) capacities among high-risk rural women. The study found that rural women with preterm birthday and multiple gestation pregnancies were less likely to give birth in a hospital with NICU capacity if no local hospital had this capacity.
  • The Practice of Midwifery in Rural US Hospitals
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 07/2016
    Analyzes the role of certified nurse-midwives (CNMs) in providing maternity care in rural US hospitals and to examine state-level variations on rural CNM practice. CNMs play an important role in the maternity care workforce in rural US hospitals.
  • Ensuring Access to High-Quality Maternity Care in Rural America
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 05/2016
    Examines the access to high-quality for rural women care during pregnancy and childbirth. Policy interventions at the local, state, and federal levels could help to address maternity care workforce shortages and improve quality of care available to the one-half million rural U.S. women who give birth each year.
  • Location of Childbirth for Rural Women: Implications for Maternal Levels of Care
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 05/2016
    This study looks into the rate at which rural women give birth at nonlocal hospitals. Approximately 75% of rural women gave birth at local hospitals. However, after controlling for clinical complications, rural Medicaid beneficiaries were less likely to give birth at nonlocal hospitals, implying a potential access challenge for this population.
  • Rural Implications of Expanded Birth Volume Threshold for Reporting Perinatal Care Measures
    Journal Article
    University of Minnesota Rural Health Research Center
    Date: 04/2016
    In 2016 the minimum annual birth volume threshold for required reporting of the Joint Commission Perinatal Care measures by accredited hospitals decreased from 1,100 to 300 births. This study used the publicly available Join Commission Quality Check data from April 2014 to March 2015.
  • Variation in Primary Care Service Patterns by Rural-Urban Location
    Journal Article
    RUPRI Center for Rural Health Policy Analysis
    Date: 03/2016
    Examines primary care physician service patterns by rural-urban location and discusses effect on recruitment strategies for primary care providers in rural communities.

2015

2014

2013

2008

2007

  • Why Are Fewer Hospitals in the Delivery Business?
    NORC Walsh Center for Rural Health Analysis
    Date: 04/2007
    This study examines the declining availability of hospital-based obstetric services in rural areas from the mid-1980s to the early 2000s. It looks at potential causes for this trend and explores the effects of medical malpractice reforms.

2006

2005

2004

2002

1997