Health care representatives and policymakers in Pennsylvania are warning of declining maternity services in rural parts of the commonwealth, a shift that’s making it harder for pregnant women in these communities to access vital care.
But as hospitals continue to close down labor units and obstetricians exit some small towns, an array of organizations are working to help fill the health care gaps left behind.
Here are a few of the resources available to rural residents who are or are planning to become pregnant:
Rural Health Clinics
The federal government established a rural health clinic program in the 1970s in response to the lack of physicians in these areas who would treating Medicare patients. By receiving a designation through this program, clinics can benefit from enhanced Medicare and Medicaid reimbursement rates.
Today, there are about 70 of these health clinics scattered across rural parts of the commonwealth, according to the Pennsylvania Office of Rural Health.
While not all of the health system’s clinics have an OB/GYN, Pierce said the primary care providers at these facilities do offer prenatal services and help connect a patient with more specialized care elsewhere.
“They will get the patient started with the prenatal vitamins, get them tested to make sure they’re pregnant, get them started on the right path,” she said.
A list of Pennsylvania’s rural health clinics is accessible at bit.ly/3t67h8V.
Federally Qualified Health Centers
One of the missions of federally qualified health centers is to provide care in underserved communities, including rural areas. They are also obligated to care for any patient, regardless of the person’s insurance status or ability to pay.
Pennsylvania has about 99 FQHC sites in rural areas, according to the Center for Rural Pennsylvania.
George Garrow, CEO of Primary Health Network, an FQHC that has sites in 16 counties, said that while his health system doesn’t operate any hospitals where someone could give birth, the organization does offer a wide range of primary care services.
Many of its locations deliver behavioral or mental health services, and the network also makes use of case navigators to help patients with their individual needs and to avert any obstacles to care, Garrow said.
Navigators, for instance, might make sure a woman gets started on her prenatal vitamins early in her pregnancy or connect her with obstetricians and other specialists.
Community health workers in the network also assist people who have trouble getting to appointments, using partnerships with transportation programs or by contracting with ridesharing services, Garrow said. And the network also operates a charitable foundation that can aid people who can’t afford the cost of their prescription medicines.
You can search for FQHCs by county and specialty at my.pachc.org/Find-a-Health-Center
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Through this program, women who are lower income can receive regular home visits from a nurse during their pregnancies and for the first two years of their child’s life.
Elizabeth Cassidy, a nurse who works in the partnership, said she aims to check in on women anywhere from once every several weeks to every week. During these visits, she’ll monitor her clients’ blood pressure, encourage them to establish healthy habits and form a trust-relationship that will continue after their child is born.
“We work with moms to achieve their own goals,” said Cassidy, whose employer, Maternal and Family Health Services, administers the nurse-family partnership program in northeastern Pennsylvania. “It’s not just baby-focused, but also to work on themselves and be the best parent that they can be.”
The nurse-partnership program traditionally is only open to first-time mothers, but Maternal and Family Health Services recently received permission also to serve pregnant women who already have children.
Information on nurse-family partnerships in Pennsylvania is available at nursefamilypartnership.org/locations/pennsylvania/
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The USA TODAY Network is covering healthcare access issues in rural parts of the commonwealth. As part of this reporting, we’re interested in hearing from Pennsylvanians in these communities who have struggled to access medical, dental and mental health care.
Fill out the form at bit.ly/pa-maternity and your response will go directly to a USA TODAY Network reporter. You may be contacted for further details about your story.