Rural Womens Health Care Needs PDF Download

Declining access to medical care is a crucial aspect of the ongoing maternalhealth care crisis in the U.S. Public discourse and existing research focus on a shortageof obstetricians, and hospital closures, as two of the primary factors that limit womensaccess to maternal health care. Declining access to care places a disproportionateburden on rural women, who must travel longer distances to care, causing themincreased physical, psychological, and financial stress and contributing to negativepregnancy and birth outcomes. Expanding on existing literature, this multiple methodsresearch identifies myriad factors that limit rural womens access to care, explores howthose factors interact to affect womens broader lives, and critically analyzes howmedicines hegemonic power contributes to declining access to care. Applying a new conceptual model for health care access, the research designcombines spatial analysis, feminist ethnography, and case studies to uncover womensexperiences accessing maternal health care while living in four rural areas ofPennsylvania. Two case studies focus on hospital deserts counties that contain nohospitals, and the other two are based in Critical Access Hospitals hospitals federally designated as such because of their remote locations and small size. Interviews withwomen, health care providers, and others coalesce to provide a more comprehensivepicture of the complexity of health care access in rural areas, and emphasize the rolesof extreme weather events, medical insurance constraints, and concentration ofspecialized care as barriers to care. Grounding my work in both social and feminist theory, I weave the findings fromthe case studies with my analysis of health care system policy and the lack of policyregarding home birth midwifery in Pennsylvania. I identify fourteen access barriers,highlight how they interact to affect womens lives, and argue that medicineshegemonic power contributes to declining access by operating at three scales of sociallife. I employ the reproductive justice framework as articulated by SisterSong to assertthe need for new and improved public policy that will increase rural access to maternalhealth care, and underscore the potential for legal home birth midwifery to fill some ofthe gaps left by declining access to medical maternal health care.