The Process and Quality of Rural Perinatal Care: A National Study


The equitable provision of high-quality obstetric care is a major priority of our health care system, and nowhere is access to such care more threatened than in rural areas. This project determined whether rural mothers receive less care and experience worse outcomes than their urban counterparts, whether racial and ethnic minorities living in rural areas experience different outcomes than their counterparts, and what other factors are associated with less care and poorer outcomes. Data were compiled from the National Center for Health Statistics’ Linked Birth/Death set and the Bureau of Health Professions’ Area Resource File. Measures of process of care included late or no prenatal care, lack of care in the first trimester, and inadequate care as measured by the Kotelchuck Index. Outcome measures included infant mortality and the percentage of children born at low and very low birthweight. This study also compared birth outcomes and process of care for minorities across rural areas and with their urban counterparts. Funded by HRSA’s ORHP.