查看文章

Access to high-quality care during pregnancy and childbirth is a challenge for women living in rural and remote areas of the United States, partly owing to shortages of childbirth providers. Policy interventions at the local, state, and federal levels could help to address maternity care workforce shortages and improve quality of care available to the one-half million rural US women who give birth each year.

Up to 40% of all US countiesdmost of them ruraldlack a qualified childbirth provider. These are places where there is not one obstetrician, midwife, or family physician attending births in the entire county (American College of Obstetricians and Gynecologists [ACOG], 2014; ACOG, 2015a; Tong et al., 2013). Workforce constraints are compounded by increasingly frequent obstetric unit closures (Hung, Kozhimannil, Casey, & Moscovice, 2016). In 2014, we conducted a survey of rural hospitals in nine states (Kozhimannil …