Maternal mortality rates tied to availability of primary care providers: Study

Skilled, high-quality health providers and birth attendants are important for reducing maternal mortality. The United States has one of the highest maternal mortality rates among developed nations and this rate has increased markedly over the past several decades.

Limited access to high-quality prenatal and maternity care services contribute to mortality risks, particularly for lower-income individuals, members of racial and ethnic minority groups, and those living in rural areas distant from health care providers and facilities.

Hence, to assess whether U.S. regional variations in maternal mortality rates relate to health workforce availability, John E. Snyder and associates from the Health Resources and Services Administration, Rockville conducted this study.

Snyder compared the regional variations in maternal mortality rates and women's health provider rates per population and identification of a relationship between these measures. Regional-to-national rate ratios for maternal mortality and women's health provider availability were calculated as per population for women of reproductive age. Provider availability was examined across occupations (obstetrician-gynecologists, internal medicine physicians, family medicine physicians, certified nurse-midwives), in service-based categories (birth-attending and primary care providers), and across the entire women's health workforce (all studied occupations).

The authors tabulated the following results-

1. Maternal deaths per population increased nationally from 2009 to 2017 and, in 2017, were significantly higher in the South and lower in the Northeast than nationally.
2. The occupational composition and per-population availability patterns of the women's health workforce varied regionally in 2017.
3. The South had the lowest available in the nation for nearly every health occupation and category studied, and the Northeast had the highest.
4. This exploratory analysis suggests that subnational levels of provider availability across the region may be associated with higher maternal mortality rates.

Hence, the authors concluded that "Regional variations in maternal mortality rates may relate to the availability of birth-attending and primary care providers."