Military medical treatment facilities could improve access to emergency obstetric care in underserved areas


In the United States, maternal mortality rates remain higher than in comparable countries, and racial disparities persist. While many countries have seen improvements in maternal mortality rates, rates in the United States have increased to about 16.9 pregnancy-related deaths per 100,000 live births between 2006 and 2016 and currently have a lower death rate. kindergarten higher than more than 50 other countries.

Longer travel times to access obstetric care are associated with poorer outcomes for mothers and babies, and only about 61.6% of the U.S. population has emergency (within 30 minutes) access to obstetric care . New study by investigators at Brigham and Women’s Hospital assesses a potential solution that could improve access: a partnership with military medical treatment (MTF) facilities, which could provide high-quality obstetric care, including a Caesarean section emergency. The researchers identified 17 facilities capable of providing care in underserved areas, especially in rural communities.

“Providing emergency Caesarean sections in underserved areas has the potential not only to improve care for pregnant patients in need of emergency access, but it also has the potential to address inequalities and support preparedness. military, ”said lead author Molly Jarman, PhD, MPH, Brigham Surgery and Public Health Center (CSPH). “We have healthcare resources that need more patients, and we have patients who need healthcare. While the needs and ability cards don’t overlap perfectly, when they do, we have the option of opening the door. “

It could be a win-win for military MTFs and civilians. There is much to be gained for both sides by reducing disparities, improving maternal care, and providing training and experience for military medical professionals. “

Tarsicio Uribe-Leitz, MD, corresponding author, MPH and CSPH

Uribe-Leitz, Jarman and their colleagues studied access to obstetric care in the United States. They examined areas within a 30-minute journey of a medical facility capable of providing emergency cesarean care. The team identified 3 MTFs that were the only facility within a 30-minute drive and 14 additional MTFs that could improve access to care.

“Better access to emergency obstetric care could save lives, Jarman said. “We see this work as bringing together a solution to two distinct problems: the reduction of preventable maternal mortality in rural areas of the United States and the ongoing political discussions about the ‘right sizing’ of the US military health care system. “


Brigham and Women’s Hospital

Journal reference:

Uribe-Leitz, T., et al. (2022) Geospatial Analysis of Access to Emergency Cesarean Delivery for Military and Civilian Populations in the United States. JAMA network open.


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