New York’s Maternity Care Deserts, Ranking Improvements With March Of Dimes Data Analyst

We have previously covered some of the issues related to maternity care deserts in our midwife interviews, with representatives from the New York Certified Professional Midwives and New Jersey Certified Professional Midwives.  Due to the prevalence of Mennonite communities in Upstate New York, they are the hidden care deserts in that they will not go to a hospital even if available, unless requested to do so by a midwife attending their birth.  Due to the lack of midwives in Upstate New York, this does not always happen, and there may well be a growing number of unreported infant and maternal deaths due to the lack of qualified midwives overall and in particular for these communities.  

According to the newest research from March of Dimes, there has been improvement in some communities that previously had low access.  Some of this improvement is from better data collection and usage.

When looking at hospital data, the fields where maternity services could be added was often left blank, but this isn’t necessarily because there were no maternity hospitals in that area.  It was a matter of getting the data correct by concatenating it with Medicaid data to get a clearer picture of what’s actually happening.

In addition, there are more providers than previously understood. One thing not considered was the Country Doctor. These are family practice physicians or general practitioners who deliver babies for their local residents. Such doctors are often overlooked in the statistics because they’re the unsung heroes no one realizes exist.  For some birthing people in rural communities, they are their only option.

However, in some places, this is welcomed and even encouraged by the GP offices.  They want to deliver babies, and it’s such a different experience.  There aren’t 50 other people around having babies, so more attention and one on one care can be given to the laboring person, often the only patient at their time of delivery.

For those who prefer to avoid the hustle and bustle of a traditional hospital maternity ward, this can be the perfect alternative.  These are doctors and nurses they know, that they’ve seen before and who will continue to care for them and their newly burgeoning family throughout their lives.  These physicians can often provide better care than a hospital anyway.

While these practitioners may not be accepted by the Mennonite communities, they do help the other residents who might otherwise have to travel long distances to receive care.  And such doctors would also receive training in neonatal resuscitation to handle many of the difficulties that might arise.

As with so many other things, people living in rural areas make do as they always have.  As March of Dimes points out, maternal mortality is a very small number, but even one death is too many.  So figuring out why they happen is valuable and important work.  What they know for certain is that getting prenatal care, having caring doctors and nurses at their delivery, and basically being in the right place when they give birth are of paramount importance.  The specific distance from hospital care may not be as important as having some care, whether midwives or family physicians.  Every woman who gets the proper care before her baby is born has a better chance of having a good birth experience.  And while maternal mortality is an important issue, maternal morbidity (or coming close to mortality as a result of the birth)  is just as important and may be easier to study and address.  Issues related to care quality and equity are also important. All of these things work together for the improvement of birth outcomes, kind of like a tapestry with many threads coming together to make a better picture.  As March of Dimes continues their work of helping moms and babies around the country, their progress and that of others in the same sphere is starting to make a difference.  But until maternal mortality is under control, the US still has one of the highest maternal mortality rates among developed countries.  Hopefully their work will change that as time goes on.

Banner Image: Maternity care desert map. Image Credit – March of Dimes