By AMY GEISZLER-JONES
KU Medical Center
Concerned about the limited availability of maternal health services in rural Kansas and the state’s high infant mortality rate, leaders with the Kansas Center for Rural Health on the KU School of Medicine-Salina campus are bringing together providers, hospital CEOs, educators, researchers, students, residents and others for a symposium.
The five-hour Inaugural Rural Maternal Health Symposium, which starts at noon Friday, Sept. 29, will address factors that are impacting care for expectant and new mothers and their babies, with topics ranging from the financial side to the latest mental health care guidelines for new moms.
As a former 15-year rural health practitioner, Lynn Fisher, M.D., the center’s associate director of service and education and an assistant professor in the Department of Family & Community Medicine at KU School of Medicine-Wichita, understands the challenges for Kansas hospitals and clinics that provide maternal services.
The symposium is a perfect fit with the center’s mission of finding ways to reduce or eliminate health disparities in rural health through collaboration with other stakeholders passionate about rural health, according to Fisher and Lisette Jacobson, Ph.D., MPA, M.A., who are helping organize the event. Jacobson is an associate professor in the Department of Population Health at KU School of Medicine-Wichita and holds a secondary appointment in the Department of Obstetrics & Gynecology. She serves as the director of the Rural Health Council and is on the center’s maternal health committee.
Critical state<br>
A clear indication of the critical state of rural health care in Kansas is a recently released report from the Center for Healthcare Quality and Payment Reform that puts the state at the top of its list of hospitals at risk of closing. Of the state’s 104 hospitals, 60 (58%) are at risk of closing, with 29 being at immediate risk. And access to maternal health services is even more dire: Only 44 hospitals in rural Kansas offer maternal health services.
“Women already have long drive times to hospitals to deliver their babies so (Kansas hospital closures) will affect maternity services. Maternal morbidity and infant mortality are also higher in rural communities,” Jacobson noted.
Kansas’ death rate among infants is more than six deaths per 1,000 births, according to the latest Centers for Disease Control and Prevention data from 2020. That’s higher than the national average of more than five deaths per 1,000 births.
Two staff members from the Kansas Department of Health and Education will give an overview of the state of Kansas’ maternal health care in the opening session of the symposium.
Hospital and patient health addressed<br>
Later in the symposium, Emily Dilley, CEO of Kearny County Hospital in Lakin, will give a talk about the financial considerations involved in offering maternal health services, including reimbursements from Medicaid and private insurers.
“We want to be a service to the community, but it can be a financial drain. We get by because we have other services,” said Kearny County Hospital’s chief of nursing, Robin Allaman, MSN, BSN, RN. The hospital delivers about 350 babies a year, with many of those being from outside the county. When Allaman worked as a certified nurse aide at the hospital more than three decades ago, the annual delivery rate was about 30.
“A lot of people, unless they’re in management, don’t understand the financial aspects of providing maternal health care. It’s just not well paid for,” Fisher said.
To address patient care more directly, the symposium will also have sessions on pregnancy complications and outcomes, which will be led by Brian Brost, M.D., a maternal and fetal medicine specialist with the University of Kansas Health System in Kansas City.
It can be difficult to access high-risk pregnancy care in rural areas so having someone share those insights is important, said Jacobson.
During his days as a rural family practice doctor, Fisher said, he appreciated having specialists he could text or call for consultations.
The symposium, which offers the opportunity for continuing education credit, will also provide information on the latest best practices guidelines from the American College of Obstetricians and Gynecologists and the U.S. Preventive Services Task Force. For example, the USPSTF is recommending more proactive guidelines in mental health referrals during prenatal care and postpartum follow-ups, Fisher said.
Who should attend<br>
The symposium is offering timely, important information for not just current practitioners in the field, but also medical school faculty, students and residents, Fisher and Jacobson agreed.
Many of the students and residents with KUSM-Wichita end up practicing in rural communities, so networking and hearing from those already “in the trenches” will be valuable, Fisher said.
As one of those in the trenches, Allaman said she’s looking forward to hearing how peers and health care professionals at other rural locations are addressing maternal health care.
“Any ideas — ways to be cost efficient, ways to be prepared for emergencies — because it’s two lives, and one is a young life, when you’re doing a delivery,” she said. “There are just many things that you can gain … even if it’s only one thing you walk away with, that one item is worth it, but usually it’s way more than that one item.”
She added, “KU has been very supportive in their rural health care initiatives, and I’ve found a tremendous amount of support throughout my career.”
The center in particular wants to be a collaborative resource, Fisher said.
That’s why the center is partnering with the Kansas Academy of Family Physicians to offer an advanced life support in obstetrics provider class on Saturday, Sept. 30, the day after the symposium, also at the KU School of Medicine-Salina campus. The registration deadline has been extended to Sept. 27; visit the KAFP website to register.
Registration is still open for the Inaugural Rural Maternal Health Symposium; visit the Kansas Center for Rural Health.