Rural Maternity and Obstetrics Management Strategies Program - National trends in maternal health have worsened over time, and this risk of maternal mortality is higher among African Americans, American Indian, Alaskan Native low-income people and rural residents. Georgia’s expectant mothers are not exempt from this statistic. In the March of Dimes 2024 report “Nowhere to Go: Maternity Care Deserts Across the US,” nearly 66% of Georgia’s 159 counties do not have an obstetric hospital or birth center. Almost 43% of these counties do not have an obstetric provider and 14.5% of counties have only one such provider. Prior to February 2025 Atrium Health Navicent Baldwin (AHNB), an acute care community hospital, located in Milledgeville, Baldwin County, Georgia, had one OB/GYN practice. This project’s target audience are women of childbearing age residing within their Health Resources & Services Administration (HRSA) designated rural area comprised of the following six (6) counties: Baldwin, Hancock, Jasper, Putnam, Washington and Wilkinson who are Medicaid eligible, at risk and/or underserved. Their goal is to serve approximately 300 women, of which 185 would receive doula supported deliveries during the grant period. AHNB operates in a geographical area designated as both a Health Professional Shortage Area (HPSA) and a Medically Underserved Area (MUA), situated between two maternity care deserts. AHNB is submitting a $4M competitive grant application to enhance its ability to address the region's obstetrics crisis utilizing the expertise of their network partners along with the goal of achieving Level I Maternal Center designation from the Georgia Department of Public Health by 2026. AHNB is a member of the Georgia Perinatal Quality Collaborative (GaPQC) initiative and located within the service delivery area of Atrium Health Navicent’s Medical Center’s (AHN MC) Regional Perinatal Center (RPC). The state has six RPCs, and AHN MC RPC is in Macon, Bibb County and covers 29 counties, inclusive of Baldwin County. In 2024, the Commonwealth Fund ranked Georgia as the 46th worst state for preventable pregnancy-related deaths and 33rd for women's health and reproductive care outcomes. Georgia is one of the top 10 states with the highest average Maternity Care Target Area (MCTA) score of 17.51 qualifying AHNB for this funding priority. Between 2014 and 2025, 15 hospitals closed their labor and delivery units leaving the state with only 67 hospitals with birthing facilities, not including two of the state’s military bases with their own birthing facilities. AHNB is one of these hospitals. This project’s network is comprised of multiple organizations, specializing in maternal health, and affords AHNB the ability to employ innovative strategies to meet the unique needs of their expectant and new mothers. The strategies focus on (a) educating expectant and new mothers, (b) providing transportation assistance to expectant and new mothers, (c) Enhancing community-based clinical education to train future Nurse Midwives and Women’s Health Nurse Practitioners in rural care settings (d) utilization of remote vital sign monitoring and telehealth support for expectant and new mothers, and (e) implementation of a doula integration and awareness pilot.
