Limited Access to Obstetric Services for the American Indian and Alaska Native Population [ID 2683412]

INTRODUCTION: American Indian and Alaska Native (AI/AN) people face one of the highest rates of maternal mortality in the United States. Access to maternity care is correlated with health outcomes; however, research on availability of maternity care in areas largely composed of AI/AN populations is limited. METHODS: We identified the 69 counties and county-equivalents in the United States with greater than or equal to 25% of the population self-identifying as AI/AN. Counties and county-equivalents were further classified as rural (micropolitan and non-core) or urban (metropolitan). We then determined the availability of hospitals with obstetric care, obstetric providers (obstetricians and certified nurse-midwives), and the number of live births in counties and county-equivalents. Maternity care deserts were defined as counties and county-equivalents having no hospitals providing obstetric care nor obstetric providers. Limited access to maternity care services was defined as counties and county-equivalents having one or less hospital offering obstetric services and fewer than 60 obstetric providers per 10,000 births. RESULTS: These counties and county-equivalents spanned 13 states, and 65 (94.2%) were classified as rural. 39 counties and county-equivalents (56.5%) were classified as maternity care deserts, and 10 were classified as having limited access to maternity care (14.5%). CONCLUSION: The findings of this study suggest that access to maternity care is limited for AI/AN populations. Increasing access to care in counties and county-equivalents largely composed of AI/AN populations is a potential avenue to improve maternal health outcomes.