State efforts seeks to improve women’s health in rural communities

By COURTNEY CULEY
Capital News Service
LANSING – New goals set by the Michigan Department of Community Health could improve women’s health in the rural areas of Michigan.
In the Mid-Michigan region, obstetric services are widely available, said John Shaski, government relations officer for Sparrow Health System. But outside of urban areas, obstetric services may be getting harder to find.
“If you’re in one of those underserved areas and you’re going to have a baby, you’re likely going to have to travel to seek obstetric services that are non-emergent,” Shaski said.
Michigan’s North Central region contains 21 counties, said Kathy Garthe, vice president for regional system development for Munson Health Care. Only seven hospitals in that region have labor and delivery services available.
Because of the struggle, the Michigan Department of Community Health joined forces with the Michigan Health and Hospital Association to improve access to obstetrics services in Michigan.
“We are trying to figure out what is the best way for women to have a place to deliver their babies,” said Olga Dazzo, director of the Michigan Department of Community Health.
Three things drive the lack of obstetrics services, Dazzo said.
Hospitals are struggling to recruit obstetricians to their areas, she said. Hospitals need more than one available doctor.
This leads to the lack of services, Shaski said. Some hospitals don’t have obstetrics units because they are too expensive to run.
The second factor is the cost of malpractice insurance, Dazzo said.
And third, how much Medicaid reimburses for the services performed, Dazzo said.
Because of all the cuts in Medicaid, some providers are refusing to take Medicaid patients, Shaski said. The reimbursement rates are extremely low.
“Every year it seems like the state cuts some form of Medicaid, whether it’s a service or reimbursement, so we find more and more primary care physicians that don’t take them at all,” he said.
A large concern is that women will give birth to a child without receiving prenatal care, Garthe said. That can lead to complications during pregnancy.
Creating access to prenatal and obstetric services is one factor that can directly reduce the infant mortality rate in Michigan, Garthe said.
In 2009, Michigan’s infant mortality rate was 7.7 per 1,000 births, according to the Michigan League for Human Services. The national average in 2007 was 6.8 per 1,000 births.
Crawford County in northern Michigan had a rate of 17.6 in 2007 making it the highest in Michigan, according to the report.
The Michigan Department of Community Health drafted a plan of action Oct. 27th and plans to add recommendations from an earlier infant mortality summit, said Angela Minicuci, public information officer for the department.
Some of the focuses include:
• improving the health care of women and girls and making the community aware of its importance
• increasing women’s health education for youth, women, families, health care providers, and the community as a whole
• creating obstetric services in low access regions of Michigan
Ensuring that women of childbearing age receive the proper care so they are in optimal health when they enter pregnancy is the plan’s objective.
By 2015, the goal is to increase the number of women 18-44 who have regular checkups by both doctors and dentists by 5 percent, according to the action plan.
Increasing the number of women who receive early and adequate prenatal care by 5 percent is the department’s goal to promote safe motherhood.
Every stage of pregnancy has risks, she said. The goal is to reduce those risks and have the healthiest babies.
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