The Diffusion of Obstetric Technology into Rural U.S. Hospitals

Abstract

We determined the distribution and sophistication of obstetric technologies in all 80 maternity hospitals in the state of Washington and examined the effect of rural or urban location, birth volume, and physician staffing on technological intensity. Although smaller and more rural hospitals refer most premature and low-birth-weight infants to regional referral centers, sophisticated prenatal and intrapartum technologies are available in the majority of even the smallest and most remote rural units. Rural hospitals have slightly lower obstetrical intervention rates than do their urban counterparts, but the differences are not great.

Abortion Services in Rural Washington State, 1983-1984 to 1993-1994: Availability and Outcomes

“…1 This is in sharp contrast to the increased availability of other reproductive health technologies in rural areas. 2 Rural women face considerable barriers when they decide to terminate a pregnancy, including long distances to a provider, harassment, monetary costs and gestational limits. 3 Providers estimate that 8% of women travel more than 100 miles for an abortion, 4 but it is not known whether the distance that women travel has an impact on such issues as when in pregnancy the abortion occurs, the type of procedure performed and the number of abortions that occur.…”

Differences in Fertility Patterns Between Urban and Rural Women in Washington State, 1983–1984 to 1993–1994

“…For example, the availability of abortion has declined for American women. This decline is more pronounced in rural areas, despite an increase in the availability of complex obstetric and gynecological services there (Rosenblatt, Saunders, Tressler, Larson, Nesbitt, & Hart, 1994). A possible consequence of decreased availability of abortion may be decreasing abortion rates and increasing birth rates.…”