Study finds poor access to obstetric and neonatal care in low-income areas

March 19, 2018, Yale University
Study finds poor access to obstetric and neonatal care in low-income areas
Credit: Yale University

A research team led by the Yale School of Public Health has found that many pregnant women in low-income areas have to travel farther than their peers to reach the nearest hospitals to deliver their babies–and the gap in accessible health care appears to be growing.

The findings are published in the Journal of Perinatology.

"This study uncovered that travel distances to a hospital obstetric unit for many economically disadvantaged has actually increased over a 10-year period and that the need for hospital-based obstetric care is even more acute," said lead author Peiyin Hung, Ph.D., a postdoctoral associate at Yale School of Public Health. "Our findings suggest that residential proximity to hospital obstetrics and neonatal care settings needs to be taken into account as travel burden might place these vulnerable women and their babies at risk."

A travel of more than 30 miles to reach hospital obstetric care is considered a geographic barrier to specialized childbirth services and is a factor in unhealthy birth outcomes, Hung said. Since recent hospital obstetric unit closures studies have found that rural hospitals are fighting with low-birth volume, staffing and financial distress, Hung and her co-authors were interested in quantifying how far rural and urban women had to travel to get the closest hospital obstetric units. In the study, the team measured travel distances in road miles for over 1.2 million women who had childbirth hospitalizations in nine geographically dispersed states in either 2002 or 2013.

Each woman's home zip code was matched to the nearest hospital, based on the one-way driving distances. Hung and her team looked at changes in residential proximity to two care settings–obstetrics and advanced neonatal services–and found travel distances to a hospital with obstetric or advanced neonatal services were getting farther and farther for women in not only rural but also lower-income communities. By 2013, the distance from a rural pregnant woman's home to the nearest hospital obstetric unit grew to as high as 143 miles—and the distance to the nearest advanced neonatal care unit was up to 190 miles.

"This study represents an important step toward identifying the need for future study of the effects of travel distances to the closest hospital care settings on disparities in maternal and child outcomes, as long distances may place mothers and neonates– particularly for those who need higher acuity care–at risk of severe morbidity and other adverse outcomes," said Hung. "Our future analyses will include examining when the loss of local services would become an issue to mothers and births, by their residential proximity prior to the services loss."

Explore further: Closure of obstetric services in BC did not affect labor and delivery

More information: Peiyin Hung et al. Rural-urban differences in access to hospital obstetric and neonatal care: how far is the closest one?, Journal of Perinatology (2018). DOI: 10.1038/s41372-018-0063-5

Related Stories

Closure of obstetric services in BC did not affect labor and delivery

November 7, 2016
The closure of obstetric services at hospitals in British Columbia did not result in an increase or decrease in frequency of adverse events during labour and delivery, according to a new study in CMAJ (Canadian Medical Association ...

Births at home and in midwifery units could signify cost savings for the NHS

April 20, 2012
Giving women who have previously given birth and who are at low risk of complications the opportunity to give birth at home or in a midwifery unit saves the NHS money, is safe for the baby and improves outcomes for the mother, ...

Pregnant women at low risk of complications can safely be offered a choice of where to give birth

November 25, 2011
Women with low risk pregnancies should be able to choose where they give birth, concludes a study published in the British Medical Journal today. Although it shows that first-time mums who opt for a home birth are at a higher ...

Home births lead to higher infant mortality at least for mothers living in poorer areas

July 27, 2015
Home births lead to higher infant mortality than hospital births, at least for mothers living in poorer areas. This is the conclusion of a new study conducted by N. Meltem Daysal (University of Southern Denmark and IZA), ...

Newborn mortality was higher for several years after large-scale closures of urban maternity units

October 3, 2012
After a series of Philadelphia hospitals started closing their maternity units in 1997, infant mortality rates increased by nearly 50 percent over the next three years. The mortality rates subsequently leveled off to the ...

Recommended for you

New technology can keep an eye on babies' movements in the womb

July 19, 2018
A new system for monitoring fetal movements in the womb, developed by Imperial researchers, could make keeping an eye on high-risk pregnancies easier.

Why baby's sex may influence risk of pregnancy-related complicatations

July 12, 2018
The sex of a baby controls the level of small molecules known as metabolites in the pregnant mother's blood, which may explain why risks of some diseases in pregnancy vary depending whether the mother is carrying a boy or ...

Study analyzes opioid overdose risk during and after pregnancy among Massachusetts women

July 11, 2018
A study of women giving birth in Massachusetts found a higher level of opioid use disorder than have studies conducted in other states. In a paper published in the journal Obstetrics & Gynecology, the research team—consisting ...

High blood pressure in pregnancy linked to mother's heart function

July 9, 2018
Pregnant women who develop high blood pressure, or have small babies, may have hearts that pump less blood with each beat.

What you eat while pregnant may affect your baby's gut

July 4, 2018
A mother's diet during pregnancy may have an effect on the composition of her baby's gut microbiome—the community of bacteria living in the gut—and the effect may vary by delivery mode, according to study published in ...

New study reveals time and day women are most likely to give birth

June 15, 2018
A new study has found that the time and day that women give birth can vary significantly depending on how labour starts and the mode of giving birth.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.