UB School of Nursing Researchers Examine Barriers to Rural Prenatal Care Access

A recent study led by Stephanie Durfee, University at Buffalo nursing clinical instructor and PhD student, sheds light on persistent challenges rural populations face in accessing prenatal care, a critical factor in the U.S. maternal health crisis.

The study, published in the American Journal of Maternal/Child Nursing, was co-authored by UB nursing PhD student Danielle Nazarenko and Associate Professor Kafuli Agbemenu.

Limited access to prenatal care in rural areas contributes significantly to the higher maternal mortality rates reported in the United States compared to other high-income countries, according to the researchers. They examined seven peer-reviewed articles investigating rural prenatal care access and found that rural pregnant women face unique challenges, including individual, socioeconomic and health care system factors.

“The study highlighted that transportation, health insurance limitations, and provider shortages remain significant obstacles,” Durfee said. “One surprising aspect was the persistence of barriers to prenatal care in rural areas despite long-standing awareness of these issues.”

Durfee says that nurse educators and employers can play a key role in addressing these barriers and contributing to the improvement of maternal health outcomes in rural areas. Her recommendations include implementing nurse-led care coordination programs to help pregnant persons access services, expanding the roles of certified nurse midwives and nurse practitioners in rural settings, optimizing telehealth services, and developing mobile prenatal clinics.

“While previous research has focused on statistical trends or specific geographic areas, this integrative review provides a broader understanding of rural prenatal care access challenges,” she said.

Durfee noted that future research is needed on telehealth and mobile clinic efficacy for reducing disparities, the role of Medicaid policy changes on prenatal care access, and the experiences of pregnant persons from diverse racial and socioeconomic backgrounds.

“Furthermore, conducting longitudinal studies to determine the long-term maternal and infant outcomes associated with rural prenatal care barriers is needed.”

BY SHANNON O'SULLIVAN