How Accessible is Maternity Care in the Fredericksburg Region?
It depends on the locality, according to the latest report from March of Dimes, a national nonprofit that advocates for improved health outcomes for mothers and babies.
By Adele Uphaus
MANAGING EDITOR AND CORRESPONDENT
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King George County is a maternity care desert and women in Stafford County have only moderate access to maternity care, according to the most recent maternity care report for Virginia released by March of Dimes.
According to the report, a locality is considered a maternity care desert if there are no hospitals or birth centers offering obstetric care and no obstetric providers (including family physicians and certified midwives or nurse midwives) within its borders.
In the greater Fredericksburg area, Orange and Westmoreland counties are also considered maternity care deserts.
A locality is considered to have moderate access to maternity care—as is Stafford County—if there are fewer than two hospitals and fewer than 60 obstetric providers per 10,000 births.
Statewide, just under 31% of counties are considered maternity deserts, which is just slightly fewer than the percent of counties nationwide (32.6%). But the percent of women in Virginia who have to drive farther than 30 miles to get to a birthing hospital is greater than the nationwide percent—14.8% as compared to 9.7%.
“The farther a woman travels to receive maternity care, the greater the risk of maternal morbidity and adverse infant outcomes, such as stillbirth and NICU admission,” the report states. “Furthermore, longer travel distances to care can cause financial strain on families and increased prenatal stress and anxiety. The distance a woman must travel to access care becomes a critical factor during pregnancy, at the time of birth, and in the case of emergencies.”
In the Fredericksburg area, women living in Caroline and King George counties travel between 17.5 and 25.7 miles to get to a birthing hospital. Women in Spotsylvania travel 6.8 to 17.5 miles.
In addition to access to birthing centers and obstetric care, the March of Dimes report looks at the availability of family planning services and the prevalence of chronic health conditions and preterm births in Virginia localities.
All five localities in Planning District 16—Fredericksburg City and the counties of Stafford, Spotsylvania, Caroline, and King George—have “very low” to “low” reproductive maternal vulnerability, which the report measures by access to family planning clinics, especially those which receive federal funding under Title X of the Public Health Service Act.
Title X clinics, according to the Virginia Department of Health, provide birth control information and supplies; cervical and breast cancer screenings; testing and treatment for sexually transmitted infections; pregnancy testing, counseling, and referrals; and physical exams.
The Rappahannock Health District operates Title X clinics in each of the five Planning District 16 localities, according to the VDH website.
Access to healthcare before, during, and after pregnancy is important in the Fredericksburg region because three out of the five localities have high percentages of both preterm births and the chronic health burdens associated with preterm births— pre-pregnancy hypertension and diabetes, smoking, and being underweight or obese before pregnancy—according to the March of Dimes report.
King George, Caroline, and Spotsylvania all have high preterm birth rates—greater than the national target of 9.4%—and a greater chronic health burden than the overall state percent of 36.6%.
Fredericksburg City has a high chronic health burden, but low preterm birth rates, possibly because women living in the city have full access to maternity and obstetric care.
Both preterm births and the chronic health burden are low in Stafford, according to the report.
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