Local Capacity for Emergency Births in Rural Hospitals Without Obstetrics Services.

The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association
Katy B KozhimannilKristin DeArruda Wharton

Abstract

Rural hospitals are closing obstetric units, and limited information is available about local emergency obstetric preparedness and capacity in rural communities where hospitals do not routinely provide this care. To describe emergency obstetric capacity at rural US hospitals that do not routinely offer childbirth services. Data from the 2018 American Hospital Association Annual Survey were used to identify a random sample of rural hospitals that did not offer obstetric services. A survey was developed based on World Health Organization criteria for obstetric emergencies. With data collected from 69 rural hospital emergency departments (48% response rate), we analyzed local capacity to support childbirth. Most responding hospitals (65%) were located 30 or more miles away from a hospital with obstetric services. Some reported having emergency room births in the past year (28%), an unanticipated adverse birth outcome (32%), and/or a delay in urgent transport for a pregnant patient (22%). More than 90% of responding hospitals had capacity for blood transfusion, intravenous antibiotics or anticonvulsants, and basic neonatal resuscitation. However, less than one-fifth had capacity to perform surgery (16%), remove retained products of...Continue Reading

References

Sep 1, 1996·Birth·T S Nesbitt
Feb 8, 2005·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·A PaxtonS Lobis
Mar 14, 2016·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Katy B KozhimannilShailendra Prasad
Feb 18, 2018·Journal of Perinatology : Official Journal of the California Perinatal Association·Peiyin HungIra S Moscovice
Mar 10, 2018·JAMA : the Journal of the American Medical Association·Katy B KozhimannilShailendra Prasad
Oct 12, 2018·Family Medicine·Jessica Taylor GoldsteinSara G Shields
Oct 17, 2018·Lancet·Ties BoermaMarleen Temmerman
Oct 23, 2019·Journal of Graduate Medical Education·Davis G PattersonLisa A Garberson
Dec 4, 2019·Health Affairs·Katy Backes KozhimannilLindsay K Admon
Jul 15, 2020·JAMA : the Journal of the American Medical Association·Katy B KozhimannilCarrie Henning-Smith

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