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Maternal Health in Rural Colorado

Maternal Health in Rural Colorado

By: Bentley Porterfield-Finn

Last year, in our efforts to better understand the maternal health landscape in Colorado, a major part of our process involved digging into existing data throughout the State and asking the tough questions to better understand the issue. A topic we kept coming back to was maternal health in rural communities. Over time, through our review of existing sources and our extensive conversations with public health and community leaders in Colorado, we learned there was a gap in the research when it comes to maternal health in rural counties in Colorado. Over the past few months, we have connected with organizations in these communities to better understand the challenges pregnant persons and mothers face in rural Colorado. Here is what we learned!

According to the latest Colorado Maternal Mortality Review Committee Report published in July 2020, there is not a significant difference in the maternal mortality rate in urban compared to rural populations in Colorado [1]. Of all the births that occurred between 2014 and 2016 in Colorado, 87.5% took place in urban counties and 9.2% took place in rural counties [2]. There are 17 urban counties in Colorado and 24 rural counties [3]. While the data reported differentiated between urban and rural, there is limited data on specifics around maternal health in our rural communities. While we were able to identify specific data points for maternal mortality rates in Denver county, the same is not true for Las Animas county.

Moving forward, we reached out to the Office of Early Childhood who provided us with additional information as it relates to maternal health; but many questions remained. Through our discussions, we connected with a variety of community-based organizations in various rural communities throughout the state. To date, we have met with public health experts and community leaders in Otero county, Montezuma county, Mesa/Montrose counties, and Pueblo/Prowers counties.

While we didn’t fill the gaps in the data, what we learned from these conversations was eye-opening and disheartening. Mothers and birthing persons in these communities struggle with a lack of access to adequate prenatal care. Many of the hospitals have staffing problems and there is a concerning shortage of physicians. This impacts prenatal and pediatric care. One organization we connected with explained that there was not a single pediatrician in their county and families and babies lack the access to care that they need to thrive. Moreover, some individuals travel up to two hours to the closest hospital. This commute can be complicated by a lack of reliable transportation, inability to leave work, or inclement road conditions. Due to these obstacles, some pregnant persons go their entire pregnancy without ever receiving prenatal care.

Other challenges these communities face include but are not limited to food insecurity and housing instability. One organization we met with shared that there are pregnant individuals who go their entire pregnancies without gaining weight, due to lack of access to adequate food or nutrition. Many parents in these communities cannot afford diapers which are not an allowable expense for persons on food stamps in Colorado. Some try to make one diaper a day work, which is stressful, unhygienic and potentially dangerous to the health of the child. Additionally, with limited employment opportunities and growing housing costs, many families face evictions. With a lack of social networks and community resources, these parents in Colorado often face these struggles in isolation, which then contributes to high rates of perinatal mood disorders.

The meetings we have had with these communities reveal a need for better data and more comprehensive access to services. Many pregnant persons in these communities do not have access to basic needs, which in turn impacts prenatal care, which can ultimately impact birth outcomes and postpartum wellbeing. It is a vicious cycle. As we look for strategies to support families in both rural and urban communities in Colorado, we are focusing on strategies that could increase access to the resources and care necessary to promote healthy moms and babies. At the end of 2021, we invested in the Tri-County Family Care Center in Rocky Ford in response to their reported gaps in access to food and transportation for the mothers in this region.

We also initiated a partnership with Pinon Project in Cortez focused on establishing a peer support group in the community. These peer-facilitated support groups (prenatal and postpartum) include health and wellness activities and connect moms with access to food and childcare. The goal is to improve mental health outcomes and we will work closely with the organization to measure impact over the course of this next year.

While we better understand the issue and are working to address some of the existing gaps for moms and kids throughout the State, here at goldbug we are just getting started!  There is so much more to learn and so much we don’t know. What we do know is that research and data are important and vital to addressing maternal health and impacting change.  The community connections we have built will allow us to grow our understanding of the needs of community members as we continue to work to ensure that every birthing person has access to the care they need for a healthy baby from Delta to Denver.

References:

[1] Colorado Department of Public Health and the Environment (July 2020). Maternal Mortality 2014-2016. https://nursing.cuanschutz.edu/docs/librariesprovider2/newsroom-documents/maternal-mortality-in-colorado-2014-2016.pdf?sfvrsn=209887b9_2

[2] Colorado Department of Public Health and the Environment (July 2020). Maternal Mortality 2014-2016. https://nursing.cuanschutz.edu/docs/librariesprovider2/newsroom-documents/maternal-mortality-in-colorado-2014-2016.pdf?sfvrsn=209887b9_2

[3] Colorado: County Designations (2016). https://www.colorado.gov/pacific/sites/default/files/PCO_CHSC_CountyDesignations_2016.pdf