Association of prenatal stress with distance to delivery for pregnant women in Western North Carolina.

Division

North Carolina

Hospital

Mission Hospital McDowell

Document Type

Manuscript

Publication Date

3-1-2023

Keywords

Infant, Newborn, Pregnancy, Female, Humans, Pregnant Women, North Carolina, Parturition, Labor, Obstetric, Canada, Prenatal Care

Disciplines

Maternal and Child Health | Obstetrics and Gynecology

Abstract

PURPOSE: Rural areas throughout the US continue to see closures of maternity wards and decreasing access to prenatal and intrapartum care. Studies examining closure's impacts have demonstrated both positive and negative effects on maternal and neonatal outcomes of mortality and morbidity. Our study aims to build on growing evidence from Canada and Scandinavia that suggests increased travel time to give birth is associated with increased emotional and financial stress for rural pregnant women.

METHODS: Pregnant patients at 7 clinic sites in western North Carolina were invited to complete the Rural Pregnancy Experience Scale (RPES) while waiting for their prenatal appointments. Results were analyzed using adjusted linear regressions to examine the correlation between RPES scores and self-reported distance to anticipated birth location as well as RPES scores with recent local labor and delivery closure.

FINDINGS: A total of 174 participants completed the survey and met inclusion criteria. For every 10 min increase in travel distance to the patient's anticipated place of delivery, RPES scores increased by an average of 0.72 points. Participants who reported a recent labor and delivery unit closure near them saw average increases of 2.52 on the RPES.

CONCLUSIONS: Our findings are consistent with the growing body of literature internationally that demonstrates the distance required to travel to delivery location is associated with increased stress among rural pregnant women.

Publisher or Conference

Midwifery

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