Abstract
Challenges in Providing OB Services in a Rural State: An Iowa Statewide Perinatal Care Program Study [36H]
Obstetrics and gynecology (New York. 1953), Vol.133 Suppl 1(1), pp.94S-94S
05/2019
DOI: 10.1097/01.AOG.0000558775.47810.18
Abstract
INTRODUCTION:Over half the hospitals providing maternity services to the state of Iowa are rural Level I centers. OB services at these hospitals are closing annually at an increasing rate (21 in the last 15 years with 8 in 2018). We determined the current obstetrical provider workforce and identified reasons for the closures of these rural OB services.
METHODS:Current OB provider workforce data were obtained by contacting all Level I hospitals via email, SurveyMonkey®ʼ’ or telephone. Reasons for rural hospital OB service closures were identified through a six question survey mailed to the chief executive officers of all 93 Level I Iowa hospitals.
RESULTS:46 rural level 1 hospitals provide OB services in Iowa. Only 35% have an obstetrician (OB) on staff, while 65% are staffed solely by Family Medicine (FM) physicians. Cesarean sections performed in these rural hospitals are done by FM only (5), general surgeons only (8) or a combination of FM and GS (13). Thus 56.5% of these rural hospitals have no OB on staff to perform surgical deliveries or respond to obstetrical hemorrhagic emergencies. Only 1/46 rural hospitals has an anesthesiologist on staff; 45/46 utilizes only certified registered nurse anesthetists. Primary reason for rural OB service closures was the inability to recruit or retain physicians willing or capable of providing obstetric care. Additional reasons included concerns regarding quality of obstetric care, medical-legal liability and financial concerns.
CONCLUSION:Several issues must be addressed to avoid a decline in access to high quality maternal healthcare in rural Iowa.
Details
- Title: Subtitle
- Challenges in Providing OB Services in a Rural State: An Iowa Statewide Perinatal Care Program Study [36H]
- Creators
- Stephen Hunter - University of IowaAmy DunbarPenny SmithJohn DagleJeffrey Segar
- Resource Type
- Abstract
- Publication Details
- Obstetrics and gynecology (New York. 1953), Vol.133 Suppl 1(1), pp.94S-94S
- Publisher
- by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved
- DOI
- 10.1097/01.AOG.0000558775.47810.18
- ISSN
- 0029-7844
- eISSN
- 1873-233X
- Language
- English
- Date published
- 05/2019
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Obstetrics and Gynecology; Stead Family Department of Pediatrics; Epidemiology; Biochemistry and Molecular Biology; Neonatology
- Record Identifier
- 9984317105302771
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