Health Care Legislature Review

The H.R.315 – Improving Access to Maternity Care Act necessitates the identification of maternity care health professional target areas within the health professional target areas (HPSA) by the Health Resources and Services Administration (HRSA). These areas within the HPSA have a short supply of professionals in maternity healthcare. The HRSA is responsible for assigning maternity care to health professionals. It is also responsible for the collection and dissemination of data that compares maternal health services’ accessibility and demand in such areas. (H.R.315 — 115th Congress, 2017-2018). This paper is a literature review on the issue of maternal care accessibility based on the above-mentioned Act. The review analyzes statistical data relating to the issue; the populace affected, and the health outcome of the issue and the Act. The paper additionally talks about the role of nursing in passing the Act.

Literature Review

Simpson (2020) examined the prolonged challenge of rural America’s lack of maternity healthcare. Many women in rural America lack access to maternity facilities and healthcare professionals who are trained in maternity care during pregnancy, birth, and after childbirth. In regions of the U.S. without licensed nurse-midwives, APRNs, obstetricians, and healthcare facilities with a maternity unit, many women have restricted access to fundamental maternal care services. They are required to make a trip for long distances to get medical attention. In 2016, 5 million women lived in counties where there was no maternity care provider or facility that offered maternal and child healthcare services, and 10 million women resided in areas where they had limited access to maternal and child healthcare.

Kroelinger et al. (2021) examined the geographic accessibility to intensive care by ethnicity and race for women during pregnancy and childbirth. Maternal care should be risk-appropriate and should aim at providing specialized care services to women at high risk during pregnancy and after childbirth. This is only achievable with the right skills, staffing, and maternal care facilities. Across the U.S., geographical access to critical care during pregnancy and childbirth is disproportional. As per the results of this study, 95.8 percent of Asian American women, 93.5 percent of Black women, 91.45 of Hispanic women, and 89.1 percent of non-Hispanic White women have geographical access to critical care during pregnancy and childbirth. Obstetric care facilities are more likely to be located in towns, cities, and suburbs, limiting access to women living in rural or remote and sparsely populated areas.

The study by Hamlin (2017) examined maternal care by the birth attendant, birth location, and birth care delivery financing. The secondary examination was based on the state of New Hampshire, and birth data from 2005 to 2012 was taken into consideration. The majority of births in New Hampshire happened in hospitals, according to the findings (98.6 percent ).

Physicians were present at 75.8 percent of births, licensed birth nurse attendants were present at 17 percent, and licensed professional midwives were present at 1 percent. The birth care delivery financing for 28 percent of all births was Medicaid, in comparison to 44.9 percent nationwide. Women with private financers had a higher likelihood of having a cesarean section than women with Medicaid or other birth care delivery financing options. The findings show that a wide range of doctors and locations provide high-quality care, offering a policy rationale for improving maternity care access and alternatives.

The Improving Access to Maternity Care Act has helped in better setting up maternity medical care experts in areas where their services are critically needed (Hamlin, 2017). The legislation has expanded the National Health Service Corps (NHSC) accessibility to maternal care shortage area data and ensured that maternity care resources are coordinated to the areas where they are desperately needed (Simpson, 2020). Furthermore, the legislation has improved maternal health, which has consequently reduced child mortality in the designated maternity care shortage area in the U.S. In these areas, providing high-quality maternity care to women during pregnancy and childbirth has proven to be critical for saving their lives and the lives of their children (Kroelinger, et al., 2021).

Role of Nursing in Passing the Legislature

Nurses are well informed that the current healthcare system is flawed and in desperate need of reform. Many nurses’ factual experiences have incited them to take up a type of advocacy to impact changes in strategies, laws, or guidelines that govern the healthcare system. Simpson (2020) claims that nursing organizations such as the American Nurses Association (ANA) used lobbyists to influence legislators on the bill, which was introduced in the United States Congress by Michael Burgess on 1^st May 2017.

Another contribution of nursing to the passage of the Act was conducting research on the availability and demand for maternity care in the United States and reporting their findings to policymakers. According to Kroelinger et al. (2021), nurse researchers discovered maternity care health professional shortages in states such as Nevada, California, Utah, and Washington. As a result, maternity healthcare professionals needed to be stationed in locations where maternity care was most needed. Nurse researchers used these findings to assist in informing decision-makers about the best strategies to improve the accessibility of maternity care in the U.S.

Conclusion

To sum up, there has been an increasing focus on rural maternal health at the local, state, and federal levels across the United States. The rising maternal death rates, as well as their uneven impact on Black, American Indian, Hispanic, and non-Hispanic white women, are a major source of concern. The H.R.315 – Improving Access to Maternity Care Act has greatly improved the identification of geographic areas where health professionals specializing in maternity care are in short supply. Lobbying and research on maternity care access were used by nurses to help pass the legislation, and their outcomes were leveraged to influence the policymakers.

References

H.R.315 — 115th Congress (2017-2018). H.R.315 – Improving Access to Maternity Care Act. Washington, D.C: Congress.gov. Retrieved from https://www.congress.gov/bill/115th- congress/house-bill/315

Hamlin, L. (2017). Comparison of Births by Provider, Place, and Payer in New Hampshire. Policy, Politics, and Nursing Practice, 18(2), 95-104. doi:https://doi.org/10.1177/1527154417720680

Kroelinger, C. D., Brantley, M. D., Fuller, T. R., Okoroh, E. M., Monsour, M. J., Cox, S., & Barfield, W. D. (2021). Geographic access to critical care obstetrics for women of reproductive age by race and ethnicity. American Journal of Obsetrics and Gynechology, 224(3), 304.E1-304.E11. doi:https://doi.org/10.1016/j.ajog.2020.08.042

Simpson, K. R. (2020). Ongoing Crisis in Lack of Maternity Services in Rural America. Perinatal Patient Safety, 45(2), 132. doi:10.1097/NMC.0000000000000605

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