ArticleHealth services research2024
Obstetric transport in rural settings: Referral and transport of pregnant patients in a state without a perinatal regionalized system of care.
Article in Health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Seasonality, Weather, and Obstetric Level of Care: An Analysis of Rural Delivery Locations.International journal of environmental research and public health · 2026Article
- Local availability of neonatal intensive care at rural hospitals with childbirth services.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Action and interaction strategies for enhancing upward referral of obstetric emergencies from community health centres in the eastern cape.Frontiers in global women's health · 2026Article
- Financial challenges of providing obstetric services at rural US hospitals.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Hospital birth volume and rurality: Associations with pregnancy outcomes among individuals with chronic hypertension.Pregnancy (Hoboken, N.J.) · 2025Article
- Examining perinatal regionalization in practice: a network analysis of maternal transport in Georgia.BMC health services research · 2025Article
- Obstetric care in rural critical access hospitals: A domestic application of the World Health Organization Emergency Obstetric Care framework in rural communities.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Obstetric transport in rural settings: Referral and transport of pregnant patients in a state without a perinatal regionalized system of care.Health services research · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectiveTo assess factors impacting obstetric transport and referral processes for pregnant patients experiencing an emergency in a rural state without a perinatal regionalized system of care. DATA SOURCES AND STUDY
settingData is from Critical Access Hospitals (CAHs) without obstetric units and healthcare providers involved in obstetric care and transport at hospitals with varying levels of obstetric capacity in Montana. STUDY
designThis mixed-methods study involved surveying CAHs without obstetric units about the hospitals' capacity for obstetric emergencies and transport policies. Survey data were collected from 32 of 34 CAHs without obstetric units (94% response rate) in the fall of 2021. Subsequent interviews were conducted in the fall and winter of 2022-2023 with 20 hospital and emergency medical services (EMS) personnel to provide further insights into the referral and transport process during obstetric emergencies. DATA COLLECTION/EXTRACTION
methodsSurvey data were collected using REDCap; interviews were conducted via videoconference. We performed descriptive statistics and Fisher's exact tests for quantitative data. We analyzed qualitative data using a three-phase pragmatic analytic approach. PRINCIPAL
findingsThe survey of CAHs found 12 of 32 facilities faced difficulties coordinating transport for pregnant patients. Qualitative data indicated this was often due to the state's decentralized transport system. Challenges identified through both quantitative and qualitative data included weather, securing a receiving facility/provider, and coordinating medical transport. Only 10 CAHs reported having written protocols for transporting pregnant patients; of those, four facilities had formal transfer agreements. Qualitative data emphasized variations in awareness and the utility of obstetric transport policies.
conclusionsA decentralized transport system in a rural state can exacerbate existing challenges faced by providers arranging transport for pregnant patients during an obstetric emergency. State and interfacility policies could enhance the transport process for increased regionalization as well as increased support for and coordination of existing EMS.
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