Barriers to maternity care in rural Kansas leave many moms-to-be miles from services
TOPEKA — Maternity care is becoming out of reach for many in rural Kansas counties, where birth rates are higher than in urban areas, hospitals face closure and obstetrics services are few and far between.
The new report from the University of Kansas School of Nursing and Hutchinson-based United Methodist Health Ministry Fund examined Kansas' maternity care deserts, or counties without nearby access to prenatal and obstetrics care.
The findings 'paint a stark picture of the current landscape of access to maternal health,' said David Jordan, president and CEO of the health fund, which commissioned and funded the report. The report was based on statewide data from 2022-2024.
'The data also emphasize the critical importance of addressing this challenge before it gets worse, as well as recognizing that the location of services is one piece of the puzzle,' he said.
More than 40% of Kansas counties don't have any maternal care services, and most Kansans live 30 miles or more from a high-risk delivery facility, the report found. Plus, most rural counties in the state do not have an obstetrician/gynecologist.
In western Kansas, Grant and Wallace counties, which sit on or near the Kansas-Colorado border, have the highest birth rates in the state. Wallace County, home to roughly 1,700 people, has no hospitals, birthing centers or facilities offering prenatal services. The closest facility offering inpatient maternity care is at least 50 miles away. In Grant County, maternity care isn't available at existing facilities, the report found, and the closest maternity care facility is at least 24 miles away.
Labor and delivery services and high-risk care are most difficult to access, the report found. About 30% of Kansas ZIP codes are 100 miles or more from high-risk pregnancy services.
Medicaid, the joint federal and state public health insurance program, pays for about 40% of all births in Kansas. After delivery, mothers are eligible for continued coverage for a year if they make an annual income less than or equal to 171% of the federal poverty level, which amounts to $47,453 or less for a family of four.
The report also revealed the unrecognized costs associated with providing maternity care, which requires the constant presence and attention of teams of nurses and clinicians. Reimbursement rates through public insurance programs can be lacking.
Addressing maternal care deserts requires sound data, said Karen Weis, the lead author of the report and dean of KU School of Nursing-Salina.
'Kansas legislators, health care systems, foundations, professional organizations and educational institutions are all working hard to address the concerns of access to care and the health care workforce,' she said.
The report highlight four priorities to improve the state's maternal health care. Providers could use telehealth more frequently as a way to expand maternal health options. Rural areas could create regional models of care so providers can more easily collaborate.
The Legislature could increase reimbursement rates for maternity care services to ease affordability concerns and retain care providers.
'Eighty-six percent of Kansas hospitals experienced a loss of services in 2023, 63% are at risk of closing and 32% are at risk of immediate closure,' the report said.
The report encouraged further engagement and research to maximize scarce resources.
Jordan said Kansas needs new, innovative solutions 'to complete the puzzle in order to provide women, children and families across the state with better access to the services they need to thrive.'
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