Indy Channel Source Article | Comments Courtesy of Matt Zavadsky
An excellent example of EMS (including community paramedics) partnering with innovative health systems in rural communities where medical care is becoming increasingly scarce.
EMS systems in rural America are being called upon to do more in these communities as the healthcare safety net provider.
Kudos to the EMS folks in Crawfordsville and their healthcare partners for rising to the challenge to fill a gap!
Maternity care deserts endanger mothers and babies in Indiana's rural communities
Nov 20, 2019
CRAWFORDSVILLE — Today is the day.
While nervous, you feel a sense of comfort, knowing you finally made it safely to and you're surrounded by doctors as you await your baby's arrival.
Some might say this is what an ideal delivery looks like. But for some women, who live in rural communities, this might not be their child-birth story. Rather, theirs is filled with anxiety and the possibility of what can go wrong.
It's hard because we have to drive clear to Lafayette," Ashley Newkark said.
Ashley and her husband Rodney, who live in Crawfordsville, are expecting twins.
"It's a good 45 minutes to the hospital that we will be delivering at," Rodney Newkark said. "And that goes the same for a real ultrasound. We have to go there 45 minutes, as well, to get the ultrasound tech."
For Katelyn Catterson, who lives just 30 minutes south, in Waveland, it's an even longer drive.
"It's an hour and 15 minutes away. I'm going to be in labor on our way to the hospital," Catterson said.
Both women have a high-risk pregnancy.
"I have pre-diabetes, but I think right now they're watching me to make sure that he doesn't develop gestational diabetes," Catterson said.
Both Newkark and Catterson live in Montgomery County, one of the worst counties in the state with access to care. The only hospital there quit delivering babies back in 2011. The nearest OB/GYN to Newkark and Catterson is based in Lafayette in Tippecanoe County.
That's where they'll have to travel to deliver their babies.
"The ambulances were delivering babies tenfold from where we were when we delivered here," Darren Forman, a community paramedic, said. "When you're living on an income that is not substantial and you have to make a decision between spending your gas money to go to the grocery store or going to an OB appointment, that's a decision."
Call 6 Investigates found 33 out of Indiana's 92 counties either have no hospitals or the hospital has no OB services where women can receive medical care before and after pregnancy. Meaning women in more than a 1/3 of our state are living in "maternity deserts."
"The OB units are decreasing, the numbers of hospitals that actually provide OB care are decreasing, and then the acuity of our patients is going up. So it's like this perfect storm of worsening, more acute patients with less resources," Lori Hardie, a simulation manager at Franciscan Health, said.
Experts say we find ourselves in a statewide crisis. Where Indiana's maternal mortality rate is the third highest in the nation and our state's infant mortality rate is the seventh highest.
Getting adequate prenatal care is critical in preventing death.
"It is difficult to get good quality providers that want to come here and stay here and be involved in the community and really make a difference," Dr. Joshua Krumenacker said.
So why are hospitals closing their doors? Turns out, it all comes down to money.
"NICUs are very expensive to staff if you can find enough staff for them, so you have a shortage of neonatologists and the facility is excruciatingly expensive," Forman said.
People are coming up with their own solutions, though. Forman decided, if women can't get the care they need, he's going to bring it to them.
Forman leads Project Swaddle in Crawfordsville, where every week he drives to patients in rural areas and sees them at their home, at no cost to the families.
And it's not just Forman.
Franciscan Health nurses based in Indianapolis have created their own training program for when things go wrong and you're an hour away from the nearest hospital.
Training paramedics in rural communities, using a breathing, high-tech mannequin to simulate real-life emergencies they'd experience in transit.
"With a pregnant mom, she could deliver in the truck for them, she could have bleeding. I mean there's just all kinds of stuff that they've got to be prepared to manage," Hardie said.
For the people trying to make a difference in these communities, the gaping hole in services for women across the state is not something to sit around and wait to change.
"This is not a problem that's going to go away," Forman said.