Obstetric Care by Family Physicians and Infant Mortality in Rural Alabama

Powell, Jessica; Skinner, Catherine; Lavender, Paul Drake; Avery, Daniel; Leeper, James D.

doi:10.3122/jabfm.2018.04.170376

Cited by 13 publications

(14 citation statements)

References 21 publications

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“…40 Moreover, studies have also found an increase in infant mortality rate where OB services are not provided. 39…”

Section: Quality Of Care and Birth Outcomesmentioning

confidence: 99%

“…Initial studies show a doubling of Infant mortality rate where counties have lost OB services, compared with a decrease in infant mortality rate where services are available. 39 Additionally, out of hospital birth, preterm birth and deliveries in hospitals lacking OB units increased. 40 Current workforce and hospital closure trends suggest that disparities in access to maternity care will only increase in upcoming years if no action is taken.…”

Section: Introductionmentioning

confidence: 99%

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Planned home births

Tedesco-Schneck¹

2020

The Nurse Practitioner

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“…40 Moreover, studies have also found an increase in infant mortality rate where OB services are not provided. 39…”

Section: Quality Of Care and Birth Outcomesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Planned home births

Tedesco-Schneck¹

2020

The Nurse Practitioner

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“…Alabama has been ranked 49th in the United States for infant mortality, which many believe is due to poor access to prenatal health care due to the closure of many rural labor and delivery units (Powell, Skinner, Lavender, Avery, & Leeper, ). Prenatal care is critical as it is linked to improved health outcomes among mothers and children.…”

Section: Policy Implicationsmentioning

confidence: 99%

Can Adoption of Cuban Maternity Care Policy Guide the Rural United States to Improve Maternal and Infant Mortality?

Bruns¹,

Pawloski²,

Robinson³

2019

World Med & Health Policy

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In the rural United States the infant mortality rate (IMR) is 6.5 per 1,000, and in rural states like Alabama this rate jumps to 9.1. Rural obstetric services are disappearing such that over half of U.S. rural counties do not have enough obstetric services. In contrast, Cuba's IMR is 4.3 while spending half as much as a percent of their gross domestic product than the United States. This raises the question: how has Cuba achieved this health outcome and what lessons can be learned and applied in the United States given decreased availability of obstetric services? This paper presents a field case study of one of Cuba's national public health policies. Specifically, we explore Cuba's Hogares Maternos, or maternity homes. We argue that the Cuban model, which focuses on social determinants of health, ought to be explored. We discuss how Hogares Maternos may be adopted and adapted within the rural United States by leveraging existing infrastructure.

show abstract

Section: Introductionmentioning

confidence: 99%

“…Alabama has the second highest infant mortality rate in the United States [1,2]. This high infant mortality rate is related to closure of rural labor and delivery units, closure of rural hospitals, lack of access to obstetric care and lack of OB/GYN and family physician obstetrics providers [2]. Lawsuits, cost of malpractice insurance, lack of trust by the community, bad outcomes, insufficient numbers of specialized nursing staff, lack of 24-hour anesthesia coverage, lack of up to date technology necessary to meet the standard of care, low reimbursement, patients with no health insurance coverage and insufficient numbers of patients who want to deliver locally contribute to the loss of local obstetric services [2].…”

Section: Introductionmentioning

confidence: 99%

Production of OB/GYN physicians to reduce the deficit of maternity providers in Alabama

Avery¹,

Reed²,

Bell³

2018

Clin Obstet Gynecol Reprod Med

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Background: Alabama has the second highest rate of infant mortality of any state in the United States. This high rate of infant mortality is related to closure of rural labor and delivery units, closure of rural hospitals, lack of access to obstetric care and lack of OB/GYN and family physicians obstetrics providers. Obstetrician/ gynecologists or family physicians trained in obstetrics are essential for hospitals to provide obstetrical care. This study was designed to determine if the production of obstetrician/gynecologists by the University of Alabama School of Medicine was comparable to other similar medical educational institutions. Materials and Methods:A list of 6271 graduates of the University of Alabama School of Medicine from the Birmingham, Tuscaloosa and Huntsville campuses from 1974 to 2015 was obtained from the published records of the main campus in Birmingham. Variables included the years of matriculation and graduation, full names, specialty choice, name and location of PGY1 institution and name and location of residency.Results: A total of 435 medical students assigned to the Birmingham, Tuscaloosa and Huntsville Campuses matched into OB/GYN from 1974 to 2015. Some 334 graduates practiced OB/GYN (84.9%). Thirty graduates switched from other specialties into OB/GYN. Twenty-two graduates who matched into OB/GYN, changed specialties or the specialty was unknown. Among the graduates who matched into OB/GYN, 67 pursued fellowships and practiced subspecialties. Conclusions:On average, 6.9% of medical students from the University of Alabama School of Medicine matched into OB/GYN compared to the national average of 5.9% The production of obstetrician/gynecologists is consistent with the most recent data from the ACOG Workforce Study.

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Obstetric Care by Family Physicians and Infant Mortality in Rural Alabama

Cited by 13 publications

References 21 publications

Planned home births

Planned home births

Can Adoption of Cuban Maternity Care Policy Guide the Rural United States to Improve Maternal and Infant Mortality?

Production of OB/GYN physicians to reduce the deficit of maternity providers in Alabama

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