Perinatal & Pediatric
Obstetric Care Facility Closures and Healthcare Provider Experiences — Fall DocStyles Survey, United States, 2023 Jessica Meeker* Jessica Meeker Jerome Leonard Carrie Shapiro-Mendoza Elizabeth Clark Rebecca Hall Romeo Galang
Obstetric care facility closures (closures) in the US have exacerbated concerns about disparities in access to quality obstetric care, which is critical as maternal morbidity and mortality rates continue to rise. The purpose of this study is to report healthcare provider closures-related experiences. DocStyles, a web-based panel survey of a convenience sample of US primary healthcare providers US, was conducted October 6–25, 2023. Providers caring for pregnant women were asked about closures experiences, including those impeding transfer of high-risk patients to appropriate care, the importance and frequency of patient counseling on facility closures, and priority counseling-related topics. We calculated experience frequencies using R version 4.0.3. The sample of 1,371 respondents included family practitioners (35%), internists (30%), obstetrician-gynecologists (18%), and nurse practitioners/physician assistants (17%). Among respondents, 53% reported closures as a problem in connecting high-risk patients to a birth facility prepared to meet their health needs; 66% of rural and 52% of urban providers expressed this concern. A third of respondents (35%), reported if the birth facility where their patients typically deliver was closed or inaccessible, they would not have an alternative, or wouldn’t have an alternative with the same level of care. Although 83% of providers reported the importance of talking with pregnant or postpartum patients about where to get emergency obstetric care in the case of closures, 54% had counseled zero, or very few of their patients. Among urban providers, 18% counseled all or almost all their patients, compared to 9% of rural providers. When asked which counseling topics should be included, providers reported knowing symptoms requiring emergency obstetric care (72%) and not waiting to seek care (66%) with the highest frequency. Provider experiences may inform efforts to ensure patients receive timely, quality obstetric care.