Work

Insights from obstetric providers and emergency medical technicians on determinants of maternal morbidity and mortality among underserved, rural patients in the United States

Year: 2023

Type: article

Abstract: Over the past two decades, individuals in the United States (US) have faced a steadily increasing risk of experiencing severe morbidities attributable to pregnancy and dying from pregnancy-related causes. The prevalence of severe maternal morbidity (SMM), defined as the occurrence of end-organ damage in the mother encompassing unexpected outcomes of labor and delivery, has nearly tripled since the turn of the 21st century (Creanga et al., 2014; Neggers, 2016). The prevalence of pregnancy related mortality (PRM), defined as the death of a woman during or within one year of pregnancy due to pregnancy-related complications or aggravated preexisting conditions, has nearly doubled (Creanga et al., 2014; Neggers, 2016). Such patterns are associated with numerous factors broadly corresponding to health status and social determinants of health frameworks (Creanga et al., 2014). Traditionally underserved pregnant patients, including those living in rural settings, are more likely to have diagnosed co-morbidities and impeded access to healthcare, elevating their risk for SMM and PRM (Hansen et al., 2021; Neggers, 2016; Petersen et al., 2019). To better understand the factors and circumstances that elevate risk of vulnerable rural residents, we examined the perspectives of patients and healthcare providers who care for patients with histories of SMM and/or PRM. This manuscript reports the perspectives of providers, including physicians trained in obstetrics and emergency medical technicians who have managed obstetric emergencies. These providers make pivotal decisions concerning patient management in complex clinical situations, and have in-depth, tacit knowledge of their regional healthcare landscape.

Source: SSM - Qualitative Research in Health

DOI: 10.1016/j.ssmqr.2023.100320

Authors: Anna Hansen, Nancy Schoenberg, Carrie Oser

Institution: University of Kentucky

Language: English

Topic: Maternal and fetal healthcare

Subfield: Pediatrics, Perinatology and Child Health

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: gold

Estimated APC paid: $1,450