Like much of the South, Georgia has long grappled with limited access to health care — particularly specialized services. This issue is especially acute in maternal health care, where the state ranks 46th nationally.
Despite efforts by advocates and policymakers at all levels to address the issue, there are still gaps in the information available on the risks pregnancy can pose for many in Georgia.
A recent study done at Georgia Tech’s H. Milton Stewart School of Industrial and Systems Engineering has filled some of those gaps by analyzing maternal transfers across the state to showcase the significant barriers many women face in accessing timely and risk-appropriate care.
“Maternal transport is a process that happens when a patient goes to a facility that perhaps doesn’t have the capabilities or specialists appropriate for their pregnancy,” Lauren Steimle, Ph.D., who led the study, explained to The Atlanta Journal-Constitution.
While transfers are typically viewed positively, indicating that patients eventually reached a facility suited for their risk, it also highlights the lack of high-level care available nearby.
“The goal of our system here is to make sure people end up at their facility that has what they need,” she said.
Steimle and her team looked at over 700,000 live birth records to find what regions of the state had the highest levels of transfer. The study found that rural patients are three times more likely to be transferred than patients in urban areas. Because of this, some hospitals are acting as “hubs” for maternal care, although they have not been designated as such by the state.
“Our research is showing some of those counties that are labeled as having full access, because they have a hospital in their county,” she explained, “but there is actually evidence here showing that those counties may have a lack of access to these higher levels of care.”
Unsurprisingly, the more rural areas of the state — particularly one part of southeast Georgia — saw the most concerning results.
“There’s kind of this region that ends up being far away from Albany and Macon and Augusta and Savannah, kind of that middle of the road pack between those cities, where there’s not one of these higher level facilities,” Steimle said. “That’s the part of the state where we saw that people were transported at these very high rates.”
A high rate of maternal transfers suggests that patients are frequently seeking care at facilities unequipped to manage their pregnancies — an issue that may also signal other health care challenges within a region.
“There have been studies showing these relationships between distance to care and worse outcomes,” Steimle told the AJC. “This is providing a different view on access that might help add to the story.”
While successful maternal transfers can be life-saving, high transfer rates in certain regions may actually exacerbate existing health disparities, according to Steimle’s research.
Addressing these disparities is complex, and there are no easy answers. Steimle points to improving prenatal education as a first step, ensuring expectant mothers know what type of care they need — and where to find it.
“Transports are a good thing in that we want to make sure people end up at the facilities that are appropriate for them, but what our study is really highlighting is those regions where people are not having access to that care at the first facility they go to,” she explained.
“We’re trying to get people somewhere with the care appropriate for their risk.”
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