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Most rural Oklahoma hospitals lack maternity care, others that do risk losing it

Oklahoma State Department of Health
Most of Oklahoma is in a maternity care desert, according to a March of Dimes report.

Oklahoma is among 10 states in the U.S. where more than two-thirds of rural hospitals lack labor and delivery services, according to a report from the Center for Healthcare Quality & Payment Reform.

The state is home to 78 rural hospitals, and 68% operate without obstetrics services. Nationally, the average travel time to receive these services in urban areas is under 20 minutes, according to the report. In rural Oklahoma, it’s 39 minutes.

This means more babies are being born outside the hospital, which can impact maternal and infant outcomes.

Oklahoma’s maternal mortality rate is on the rise, according to a recent report from the Oklahoma Maternal Health Task Force. It went from 25.2 mothers per 100,000 live births during the 2018-2020 reporting period to 31 per 100,000 in the 2019-2021 period.

A portion of the remaining rural hospitals with these services could also be in jeopardy of losing them.

Hospitals require 24/7 access to physicians and nurses to provide high-quality maternity care, but it can be challenging to fund adequate staff when rural hospitals are experiencing losses in other patient services. Out of the remaining 25 hospitals with obstetrics services, 48% are losing money on other services.

Oklahoma has lost 10 rural hospitals since 2005, and it could be on its way to losing more. Of its 78 rural hospitals, 33 are at risk of closing, and 22 are at an immediate risk. Officials from the Center for Health Care Quality and Payment Reform say this can be based on numerous factors, including losses of patient services and low financial reserves.

The answer to this issue is multi-faceted, and the report offers a few recommendations.

The first is to address existing staff shortages by recruiting and training medical students to deliver care in rural areas. Oklahoma State University, for example, provides a rural medical track, which allows students to prepare for a rural primary care residency.

The report also recommends employers require health insurance and Medicaid plans to pay amounts that adequately cover maternity care services. The cost to insurance companies for having staff available 24/7 can be the same between rural and urban hospitals, and this method would ensure better access to services.

“Every day that steps are not taken to implement the changes in workforce recruitment and payments described above increases the likelihood that more women and babies will die unnecessarily,” the report reads.

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Jillian Taylor has been StateImpact Oklahoma's health reporter since August 2023.
Anna Pope is a reporter covering agriculture and rural issues at KOSU as a corps member with Report for America.
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