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Colorado looks to midwives to solve the state's labor and delivery care shortage

A MARTÍNEZ, HOST:

More than half of America's rural hospitals lack labor and delivery services, and every year, more units close. The University of Colorado is trying to help narrow the gap by training nurse midwives to work in rural areas. Here's Colorado Public Radio's Rebecca Tauber.

REBECCA TAUBER, BYLINE: A big, fake, pregnant belly is the center of attention for a group of nurse midwifery students at University of Colorado's College of Nursing. Standing behind the hollow stomach, an instructor pushes a fake baby out the birth canal, mimicking childbirth.

UNIDENTIFIED PERSON: Can we do another big push?

(SOUNDBITE OF GROANING)

TAUBER: Students take turns coaching the plastic torso on how to push and catching the very slimy, very fake baby that comes out the other side.

UNIDENTIFIED PERSON: OK. so we'll go ahead and move into McRoberts, bring the legs up, but otherwise, we'll try and turn.

TAUBER: The patients might be fake, but the skills are real and in short supply.

KATY KOZHIMANNIL: A lot of my friends in high school became pregnant. Their access to care was really limited.

TAUBER: Katy Kozhimannil grew up in rural Minnesota and North Dakota. Now director of the University of Minnesota's Rural Health Research Center, she found that 9% of the country's rural hospitals lost labor and delivery care between 2010 and 2022. With rural hospitals struggling financially and abortion bans in some states pushing providers away, Kozhimannil says rural America has a maternal health care crisis.

KOZHIMANNIL: We will continue to see closures and we will continue to see moms die until we have a system that pays for valuing their health and pregnancy and needs.

TAUBER: Labor and delivery units are expensive and difficult to staff because they have to be ready for birth at any time. Kozhimannil says training more nurses in midwifery could help.

KOZHIMANNIL: Several hospitals that have had to close maternity units have had to do so because of nursing, lack of nursing support.

TAUBER: Shannon Pirrie is the director of University of Colorado's nurse midwifery program.

SHANNON PIRRIE: I think we got into this because our country doesn't value women's health as much as they should, and the prioritization is tough in rural communities.

TAUBER: Last year, Pirrie's school was one of 10 in the U.S. that got federal grants to support midwifery master's education. Students trained as midwives learn to take the lead in low-risk pregnancies. Some studies show that they can improve pregnancy outcomes. CU focuses on training students to work in rural areas. If graduates work in one for two years, they get full tuition and a stipend. Tessa Huizenga is a nurse midwife student from Lusk, Wyo.

TESSA HUIZENGA: I have that flexibility that I can go to a rural setting where realistically, I probably won't get paid as much and not have to worry about having debt, like, hanging over my head. That makes a big difference.

TAUBER: When Huizenga was born, her mother drove two hours to the nearest hospital for prenatal care.

HUIZENGA: But there's a lot of people that just don't understand what access to care can look like.

TAUBER: CU students do clinical rotations in rural areas, and the school helps them build a network of midwives in surrounding clinics and hospitals. They also get extra training on things like caring for patients with substance abuse disorder who might not be able to get help locally. The federal grant is funding the school's rural track for four years with a potential four-year extension. The head of its nurse midwifery program wants the added training to become permanent.

For NPR News, I'm Rebecca Tauber. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

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