Over 40% of Missouri’s 114 counties are considered maternity care deserts, according to a recent March of Dimes report. Most of those 48 counties are rural and do not have access to obstetrics care or birthing hospitals.
Jamaa Birth Village is piloting a midwifery satellite program that will offer prenatal and postpartum care next year to pregnant people near Springfield, Columbia and the Bootheel area to help reduce the health disparities among Black women living in rural areas. The midwifery clinic will also pilot the satellite program in St. Louis.
The services can help bridge the maternity care gap in rural communities where accessibility and affordability is an issue for Black families, said Okunsola Amadou, founder and CEO of Jamaa Birth Village, a Black midwifery and maternal health care center in Ferguson.
“Black women deserve to be seen and heard, and most definitely to receive care by people who share their background and their experiences,” she said. “What we understand about rural care centers, these are mostly white providers that live in those specific cities that were raised in communities where they did not necessarily have healthy, abundant relationships with Black or brown people.”
Recent hospital closures in outstate Missouri cities and terrifying birthing stories from some of Amadou’s partners in the Bootheel area pushed her to find ways to create access to maternity care for rural families. She said many had negative experiences at one of the hospitals in the area, and it could take people up to an hour to get to another hospital.
Jamaa Birth Village is working with groups and organizations in Springfield, Columbia and the Bootheel area to decide upon the proper locations in those areas for satellite maternity care. It received a one-year, $100,000 grant from a private foundation to help with setting up satellite operations, training and orientation by the spring. Amadou expects to accept patients by October.
Through the satellite program, low-risk maternity care patients will have access to weekly midwifery visits, and doula care will be available for any patient. Satellite locations also will provide pregnant people with access to breast pumps, formula, bottles, diapers and menstrual postpartum care kits. Jamaa’s satellite services also will offer maternity education workshops to the community.
A satellite midwifery clinic will help fill the void from a lack of maternity doctors in rural areas, said Cynthia Dean, CEO of Missouri Bootheel Regional Consortium, a health care nonprofit in Sikeston.
“We still are living in post COVID, even though it's not there, the health care system was already sort of fragile, but it's sort of flipped it even more,” she said. “So you have a lot of nurse practitioners that see a lot of the women when they go in for care versus a doctor.”
Dean said families are still feeling the effects of the closure of the Twin Rivers Regional Medical Center in Kennett in 2018. According to the March of Dimes report, many counties in the Bootheel region are maternity care deserts.
“The need is there, everybody knows that, but it's hard when you don't have the staff and the capacity to fill all the needs in these counties,” she said.
Dean worries about families who have difficulty finding transportation to service their maternity needs. Her organization monitors its clients’ due dates out of concern they could go into labor while driving miles to the nearest maternity hospital. Some clients even travel to Arkansas or Tennessee to give birth because hospitals there are closer than the nearest Missouri hospital.
“Some of those counties have no care where that hospital closed down whatsoever — they have maybe some clinics or different things — but just think what a midwifery center, a birthing center would do if it was in that community.”