FERTALY: MOMS: A Qualitative Study of Emergency Obstetric Services: Care, Referral, and Transport in a Rural State
Project Description:
Perinatal regionalization and risk-appropriate care are strategies for improving health outcomes by defining healthcare facilities' level of maternal and neonatal care and creating a coordinated regional system of obstetric care. This allows pregnant people to be cared for at facilities with appropriate resources and capabilities to reduce maternal morbidity and mortality. Referral and transport to higher-level facilities are critical components of risk-appropriate perinatal care. Effective maternal and neonatal transport is particularly important in rural areas7 where obstetric unit closures, staffing shortages, and long travel times are barriers to accessing obstetric care.8,9 The Montana Obstetric and Maternal Support (MOMS) program has previously conducted two studies to assess Montana's system of obstetric care. In a study of non-birthing facilities in Montana (e.g., Critical Access Hospitals), the MOMS program found these facilities may need to provide care during obstetric emergencies, with 34% of respondents indicating a close call or other adverse birth outcomes at their facility. Additionally, 59% of non-birthing hospitals must transport obstetric patients more than 100 miles to reach a Maternal Level II or higher facility. Over a third (37%) of respondents experienced challenges arranging transport for a pregnant patient. Drawing on these findings, the MOMS research team is conducting a qualitative study of transport and referral during obstetric emergency events to assess challenges encountered during the organization and delivery of care between facilities in Montana.
We are conducting semi-structured interviews with healthcare providers involved in the provision of care during obstetric emergencies including emergency department health care providers, obstetric care providers, and maternal transport team members. Participants at facilities across maternal levels of care will be asked to describe their referral and transport processes during obstetric emergency events in Montana, challenges faced during referral and transport, and how staff are impacted by vicarious trauma of an obstetric emergency.
The challenges identified by participants will be used to assess the current state of, or the need for, perinatal regionalization of care in Montana. The results will provide a starting point for discussion among stakeholders on improving communication and coordination of care during obstetric emergencies.
Keyword(s):
Rural, Maternal Health, Emergency Obstetric Services, Transport, Referral
Core Function(s):
Performing Research or Evaluation, Developing & Disseminating Information
Area of Emphasis
Health-Related Activities
Target Audience:
Professionals and Para-Professionals
Unserved or Under-served Populations:
Geographic Areas
Primary Target Audience Geographic Descriptor:
State
COVID-19 Related Data:
N/A
