medical-stethoscope

*A troubling new study has found that the accessibility of obstetric care in rural areas continues to shrink, putting both mothers and infants at risk. But data shows that African American women, in particular, are disproportionately impacted with very few viable solutions.

Nationwide, more than two dozen rural hospitals have shuttered their doors since 2013. Around 54% of rural counties throughout the country had no hospitals that offer obstetric services in 2014, compared to 45% in 2004. Since 28 million women of childbearing age live in rural counties throughout the U.S., these statistics mean that these women often have intense burdens to bear during their pregnancy and delivery.

For many of these women, they might have to go to a prenatal doctor located hours away. Once they go into labor, they may have to drive more than two hours to find a hospital with a maternity ward.

North Carolina residents have seen several maternity care centers close within a short amount of time, leaving many expectant mothers without any nearby options throughout their pregnancy and during delivery. In 2015, nonprofit hospital network Mission Health started to close their small labor-and-delivery centers throughout the region. The Transylvania Regional Hospital in Brevard, which serviced nearly 33,000 residents, closed first, followed by Angel Medical Center in Franklin, which left 40,000 people without access. Blue Ridge Regional Hospital of Spruce Pine closed last month, rendering 33,000 in surrounding counties without a local hospital. Now, these residents will likely have to drive through the mountains — the highest in the eastern part of the U.S. — to get to a hospital. It’s a precarious situation, to say the least.

Situations like these are a huge concern for the African American community, especially. The rural counties that are most effected by these closings are more likely to have residents with lower median incomes and higher percentages of African American women. Women who live in these rural areas are more likely to be in fair or poor health, smoke, and struggle with obesity. Now, these women are less likely to have access to a hospital with a maternity ward, too.

Typically, these closures happen due to high operating costs, fewer high-end patients, low physician pay, and even higher risk of medical malpractice. But as Katy Kozhimannil, a professor of health policy and management at the University of Minnesota, pointed out to the Huffington Post, the buck doesn’t stop here just because the hospital decides it’s too expensive to continue operations.

“We cannot ignore the fact that when a health care system or a hospital decides that it’s no longer worth the risk to keep the obstetric unit open, that risk does not go away, said Kozhimannil. “It migrates from the hospital to the homes of the people living in that community.”

While residents may not be able to prevent hospital closures, CBS News has a few recommendations for families who are impacted. Expectant moms should have a transportation plan in place and rely on someone who has the flexibility, finances, and know-how to get them to their facility. Families may be able to find out about state programs that will cover these transportation costs. Some experts recommend to not wait until contractions are five minutes apart to go to the hospital. Standard maternity advice like this could result in a car-bound birth, rather than one in a hospital. And many families may benefit from finding somewhere to stay that’s located nearer to their hospital of choice in the days leading up to the birth. While it may not be ideal, it could make a huge difference in terms of stress and comfort during delivery.