Maternal Health Workforce
Providing adequate access to maternal health services for women can be a challenge for many rural communities.
Health centers are often few and far between and skilled providers are limited. Nearly half of the counties in
the U.S. do not have access to a local obstetrician.
In rural areas, it is more common to find family physicians than obstetricians attending births. Yet the number
of family physicians (FPs) attending births in rural communities has decreased.
There are many factors contributing to this decline in FPs attending births in rural communities, including lack of birth volume and resultant inability of FPs
to maintain competencies in maternity care. Additionally, rural FPs reported a broader scope of practice than their urban
counterparts, which could lead to greater feelings of overburden
by caring for community members across the life course.
Shortages of healthcare providers, public health nurses, and human
service personnel that support mothers and families are important barriers to maternal health in rural
communities. These include shortages of:
Public health nurses (PHNs) play a critical role in filling gaps in maternal health services. As with other
healthcare professions, there is a shortage
of PHNs in rural communities due to an aging workforce, insufficient funding, low salaries, lack of
qualified applicants, and poor recruitment and retention efforts. Additionally PHNs provide
services to community members across the lifespan, from infants to seniors. This vast experience
contributes to having additional responsibilities, leading to a circumstance called complexity compression, which is
unsustainable and contributes to burnout. This can lead to further workforce shortages.
nurse-midwives also play an important role in addressing rural maternal health workforce shortages.
Programs are offering distance education opportunities for nurses already practicing in rural communities.
Students are then given opportunities for clinical rotations in their rural home regions. Increasing the number
of midwives in rural communities may help address shortages in available family physicians and obstetricians.
For more information on addressing maternal workforce shortages, see Module 6: Maternal Health Workforce
For more information on the rural healthcare workforce, see the Rural
Healthcare Workforce Topic Guide.
Resources to Learn More
Nurse-Midwives and Rural Health Care
Overview of the role of certified nurse-midwives and certified midwives when providing rural care. Includes
frequently asked questions related to licensing, reimbursement, and required education and credentialing.
Describes several rural midwifery practices.
Organization(s): American College of Nurse-Midwives