Equity in maternal healthcare: femtech holds the key for rural hospitals

In the last 20 years, 184 rural hospitals in the United States have closed. Today, nearly 700 more of them stand at risk of closing. Of those that remain, less than half (45 per cent) provide labor and delivery services.

As a result, more than two million women of childbearing age live in a county completely devoid of obstetric care, and an additional three and a half million women live in a county with limited access.

The four sentences above stir a sense of sadness or anger in many of us. I appreciate my partners in progress, who acknowledge the depth of the maternal care problem and who are eager to build solutions that create a healthier future for our underserved family members, friends, and neighbours.

What won’t work

Let’s start with some “solutions” that I wholeheartedly reject.

I founded an onsite sonography services company nearly 20 years ago. At that time, rural hospitals and clinics were feeling the early pains of a sonographer shortage — a shortage that, today, has grown into a very real crisis.

The numbers of rural physicians, maternal-foetal medicine specialists, and nurses with obstetric experience have continued to dwindle dramatically over this time.

We’re left with thousands of healthcare vacancies that greatly exceed the number of professionals available to fill them (a difficulty my recruiting team works to overcome daily). So, sadly, the answer to our problem isn’t simply to “hire more people.”

Rural hospitals aren’t closing just because they can’t hire the right people, though. They’re closing because they can’t continue to operate at a loss.

Unfortunately, insurers usually pay for maternal services on a per-birth basis. This model works well for hospitals with high volumes of births per year but largely fails rural facilities.

Payments from a low volume of births throughout the year typically aren’t enough to cover operating costs for a rural obstetric department. If other service lines, like emergency and primary care, are also operating at a loss, the hospital has no choice but to close its doors permanently. These facilities are often patients’ last resort, so the answer can’t be to “allow unprofitable healthcare centres to close.”

Financially bolstering tech solutions

Although the system is inherently full of challenges, I do hold on to hope. Developments in femtech make me believe that real solutions are in the pipeline. We’ve seen these problems and responded with efficiency-supporting solutions like telemedicine, remote monitoring devices and AI.

Access to this depth and breadth of maternal-foetal support gives rural providers and their patients so many benefits.

Remote diagnostic tools, like TeleScan, provide an immediate connection to expert sonographers who can identify high-risk pregnancies and anomalies that require additional care. Remote monitoring devices provide round-the-clock data collection and can initiate care and expedite time to treatment.

With telemedicine, local providers can collaborate on treatment plans that keep their patients close to home, limit travel and financial stress, and create peace of mind. Through their exchanges, providers and remote experts also engage in knowledge sharing, building local expertise that enhances care levels for years to come.

AI-enabled tools increase efficiency and clear mundane, tedious, or repetitive tasks from staffer to-do lists. And they aid in patient communication, providing timely responses and assisting with scheduling tasks and documentation.

All these benefits—and there are so many more—are impossible without modern technology. Thankfully, the technology is there, and it’s getting better every day. It’s our responsibility to harness it and make it work for rural hospitals that are on the brink of closure.

The challenge we have to face

There is one last piece of the puzzle to discuss, and that’s the financial component. Our challenge is to make our technology affordable for the most vulnerable systems.

In a world where femtech is repeatedly undervalued, and funding is frustratingly difficult to procure, this is our challenge.

Finding the intersection of prosperity and purpose may impact the investment and attention maternity care requires. It’s up to us to find funders and founders who feel the same way we do.