Charleston, South Carolina (WCBD) – More women are living without maternity care in South Carolina, according to new maps.
Published by the University of South Carolina (USC), this map shows the number of clinics, hospitals, licensed midwives, and other female health care providers available in the state.
Thousands of women across the state live in the desert of maternity care. Areas with no hospitals or birth centers to provide obstetric care, and no maternity care providers.
The map also highlights the inadequacy of maternity care in rural areas of the state. Five of his counties in South Carolina, including Arendale, Barnwell, Greenwood, Saluda, and Williamsburg, currently have limited or no medical services related to pregnancy and childbirth. not.
“There are some counties where someone has to travel 30 minutes to an hour or more to get to an antenatal care provider.
And the problem of rural healthcare disparities is worsening across the state, supporters say.
“The number of our care desserts is growing,” said the director of maternal and infant health at March of Dimes in Tameka Wilson, South Carolina. Department clinics may have been closed in rural areas.”
The maternity care desert may contribute to the lack of prenatal care during pregnancy and treatment of pregnancy complications.
A March 2022 report found that 18% of South Carolina mothers received inadequate prenatal care, compared to 14.5% nationally.
“Certain issues that can arise during pregnancy can be targeted during that time,” she said. and may miss unexpected issues during delivery.”
Luchok said areas with fewer services also tend to have lower quality birth outcomes, including higher infant and maternal mortality rates.
“A lot of people go in and out of care and they don’t have them. [preexisting conditions] Adequately addressed, leading to a deficit and increased risk leading up to pregnancy. ”
A DHEC study found that approximately 62% of maternal deaths in South Carolina from 2016 to 2020 were pregnancy-related, and more than two-thirds of those deaths were preventable. .
However, these results are even more pronounced among women of color, who have 2.4 times higher maternal mortality rates than white women, according to the same study.
“This is like a 200-year gap that hasn’t improved much,” says Luchok.
Overall, March of Dimes gave the state an “F” grade for premature birth. This is a factor in infant mortality. Her 2022 infant mortality rate in South Carolina was 6.5 compared to her 5.4 nationally.
“If we can make prenatal care very accessible to the largest number of people in the state, we will probably have better birth outcomes,” Luchok said.
“Unfortunately, your zip code affects your baby’s health.”
This disparity can be explained in part by unequal access to health care and the need for some pregnant women to travel long distances to receive services.
For example, there are no maternity service providers in Allendale, South Carolina, so a pregnant woman must travel at least 15 miles to the nearest clinic in Hampton, South Carolina. .
“If you don’t care and you’re in the country, what else is the area lacking?” Wilson asked. “Do you have limited access to food or grocery stores, transportation issues, or being an hourly employee can also make a difference?”
Wilson added that disability is forcing some women to give up prenatal care and education that benefits themselves, their babies, and their families.
Lawmakers and advocates calling for policy change
The March of Dimes highlights several policy changes that will improve the problem of maternity care deserts across South Carolina.
One of these solutions is to extend Medicaid coverage within the state to individuals below the federal poverty level of 138%. The nonprofit KFF estimates that more than 105,000 uninsured adults would be in the coverage gap if Medicaid were expanded statewide.
“The state has a huge number of births covered by Medicaid,” Luchok said. “There’s a women’s income extension that expands when someone gets pregnant. So if someone gets pregnant, they can get Medicaid, even if they weren’t eligible before the pregnancy.”
The organization also advocates for the use of alternative birthing services such as midwives and doulas. Midwives and doulas are licensed to carry equipment and medicines in South Carolina and require years of training and apprenticeship. The problem, however, is that most are concentrated in urban areas and are often not covered by insurance.
“The doula can be someone who can help with that educational component and that care component just to fill that gap, rather than replace the obstetric visit,” Wilson explained. “Nationally, we are working on legislation to make doula care reimbursable so patients can use their insurance to pay for this extended care.”
Rural health disparities are also getting a lot of attention in state legislatures, with legislators touting it as a top priority heading into the 2023 legislature.
According to South Carolina Senate Majority Leader Shane Massey (R-Edgefield), one step to improving healthcare in rural areas is to eliminate the required certification for new and expanded facilities statewide. That’s it.
The Certificate of Need is approved by DHEC and can be challenged by competing over the healthcare system, a process that can take years.
Proponents of abolition, such as Senator Massey, believe the process is outdated, while opponents, such as the South Carolina Hospital Association, say it will protect rural hospitals and cause competition to overwhelm hospitals. It is said that it can prevent spending on
A bill to repeal the requirement passed the Senate last year but stalled in the House. Senator Massey said he expects the issue to be taken up again in the Senate early in the session.
Desert South Carolina residents of maternity care can use USC Maps to find services and providers near them.