New story in Health from Time: Many Pregnant Women Live Too Far From a Doctor to Get Regular Care. Here’s How Technology Can Help
For anyone who is pregnant, having a hospital delivery room nearby means knowing that when the baby arrives medical assistance will be close at hand. But for too many of those in rural America, this comfort is often no longer available—and it is putting both women and babies at risk. In fact, the United States is the only industrialized nation with an increasing rate of maternal mortality and this problem hits women of color especially hard.
The facts are stark. Between 2004 and 2014, 179 rural counties across the country lost access to in-county hospital obstetric care. As a result, over half of rural counties no longer have a hospital with a maternity ward. All in all, more than 5 million women now live in maternity care deserts that have no facilities offering obstetric care.
Giving birth is hard work. I can personally attest to that. It gets even more difficult if each visit with a healthcare professional to monitor everything from blood pressure to blood sugar is far from home. That means even routine appointments can require a full day of travel, time off from work, forgone wages and special arrangements for childcare. Earlier this month I visited a hospital in rural Socorro, New Mexico, with Congresswoman Xochitl Torres Small and learned that many of their patients hitchhike across vast distances and then walk for miles simply to get the maternity care they need. Because this travel is so taxing, some women show up for care only once — when they are about to give birth. But failure to regularly monitor the small things during pregnancy can have big consequences. As the Centers for Disease Control has reported, lack of access to nearby care and missed or delayed diagnoses are significant factors in pregnancy-related deaths.
It is heartbreaking to see how difficult it is to welcome new additions to families in rural areas without the support needed for a healthy pregnancy. But solutions to this crisis exist — and technology can help. The Federal Communications Commission has a long history of working to promote access to telehealth in rural communities. In the Telecommunications Act of 1996, Congress charged the agency with providing support to rural healthcare centers to assist with the cost of communications used to offer medical care. As a result, healthcare providers in some of the most remote areas of the country count on the FCC to stay connected to provide a range of medical services, including timely expertise from specialists at a distance.
As an FCC commissioner, I think we can do more to help address pressing problems in healthcare — like maternal mortality.
The FCC could start by developing data exploring the connection between broadband deployment and access to maternal care. The FCC has already done similar work mapping the incidence of diabetes and the presence of internet service. By working with the Centers for Disease Control and providers on the ground, we could create a picture of where maternal mortality rates are especially high and where critical telehealth resources need to be deployed.
Next, when it comes to resources the FCC has proposed a $100 million pilot program to explore connected care. The idea is that instead of just connecting providers, the agency should explore connecting providers to patients. For maternal care, this approach has special resonance. At the University of Arkansas for Medical Sciences, for instance, I recently saw how a team of healthcare professionals is experimenting with remote video monitoring to improve maternal care in the Upper Delta and reach patients who might otherwise not see a doctor until delivery. At the Mayo Clinic, in Rochester, Minn., meanwhile, they are exploring how expectant mothers could use wireless connected-care technology at home to communicate critical healthcare measurements with their providers. This technology could lead to fewer routine visits and improved health outcomes for pregnant women, and properly developed, the FCC’s pilot program could provide support across the country for the extension of these efforts in rural areas where obstetric care is no longer nearby.
In addition, the FCC should revisit its recent proposal to slash the Lifeline program. This program began during the Reagan Administration and today provides more than 7 million low-income Americans with access to low-cost communications. Many of those who rely on Lifeline live in rural communities. When a pregnant woman is in need of healthcare, having a Lifeline-supported phone can mean the difference between securing regular care and going without.
Finally, the FCC should identify how its work can support the initiatives proposed in the Rural MOMS Act, which was introduced in both the House and Senate this year. This bipartisan legislation would expand initiatives to address maternal health in remote areas, including training for those seeking to practice obstetric medicine in rural communities, funding to increase access to technology for pregnancy care and additional data collection and reporting on maternal mortality.
Given the extent of this problem, the single most important thing to do is get started. Reducing the rate of maternal mortality in this country will make women safer and the next generation stronger.