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Research ArticleOriginal Research

Effect of Access to Obstetrical Care in Rural Alabama on Perinatal, Neonatal, and Infant Outcomes: 2003-2017

John B. Waits, Lacy Smith and Daniel Hurst
The Annals of Family Medicine September 2020, 18 (5) 446-451; DOI: https://doi.org/10.1370/afm.2580
John B. Waits
Cahaba Medical Care, Centreville, Alabama
MD
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  • For correspondence: John.Waits@cahabamedicalcare.com
Lacy Smith
Cahaba Medical Care, Centreville, Alabama
MD
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Daniel Hurst
Cahaba Medical Care, Centreville, Alabama
PhD
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    Table 1

    Locally Available vs Unavailable L&D Services for Rural Alabama Counties, 2003-2017 (N = 36)

    Counties With L&D (n = 15)Counties With No L&D (n = 21)
    Baldwin, Chambers, Clarke, Coffee, Covington, Cullman, Dallas, DeKalb, Escambia, Franklin, Jackson, Marshall, Monroe, Talladega, TallapoosaBarbour, Bullock, Butler, Chocta, Clay, Cleburne, Conecuh, Coosa, Dale, Fayette, Lamar, Macon, Marion, Perry, Pickens, Pike, Randolph, Sumter, Washington, Wilcox, Winston
    • L&D = labor and delivery.

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    Table 2

    Comparison of Demographics of Rural Alabama Counties by L&D Service Availability, 2003-201728 (N = 36)

    CharacteristicCounties With L&D (n = 15)Counties With No L&D (n = 21)
    Mean population (2010), No.19,75159,240
    White, %60.8673.47
    Black or African American, %36.2322.76
    Latino and Hispanic, %2.785.48
    Median income (2014-2018), $35,60440,759
    Per Capita income (2014-2018), $20,64122,474
    • L&D = labor and delivery.

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    Table 3

    Comparison of Outcomes for Counties With Continuous L&D vs No L&D from 2003-2017a

    Outcome MeasureCounties With L&DCounties With No L&D
    Infant MR, No. per 1,0007.899.23
     Live births, No.165,52572,177
     Infant deaths, No.1,306666
    Low birth weights, %9.8610.61
     Live births, No.111,39348,568
     Low birth weights, No.10,9865,152
    Perinatal MR, No. per 1,0008.8910.82
     Live + still births, No.165,5251,479
     Perinatal deaths, No.72,659786
    Neonatal MR, No. per 1,0004.745.67
     Live births, No.166,42572,177
     Neonatal deaths, No.784409
    • L&D = labor and delivery; MR = mortality rate.

    • ↵a Data for low birth weights only available for 2003-2014.

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The Annals of Family Medicine: 18 (5)
The Annals of Family Medicine: 18 (5)
Vol. 18, Issue 5
September/October 2020
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Effect of Access to Obstetrical Care in Rural Alabama on Perinatal, Neonatal, and Infant Outcomes: 2003-2017
John B. Waits, Lacy Smith, Daniel Hurst
The Annals of Family Medicine Sep 2020, 18 (5) 446-451; DOI: 10.1370/afm.2580

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Effect of Access to Obstetrical Care in Rural Alabama on Perinatal, Neonatal, and Infant Outcomes: 2003-2017
John B. Waits, Lacy Smith, Daniel Hurst
The Annals of Family Medicine Sep 2020, 18 (5) 446-451; DOI: 10.1370/afm.2580
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Subjects

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Keywords

  • health care quality, access, and evaluation
  • infant mortality
  • obstetrics
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