Impact of the COVID-19 pandemic on rural obstetrics practices in New Mexico

CONTEXT: During pregnancy, the immune system is altered, putting women at increased risk of complications from respiratory viruses. There is limited information about the effects of COVID-19 on pregnant women and obstetrics programs, particularly in rural regions. AIMS: Most published reports have been from large urban hospitals. This study sought to gain insight into how the COVID-19 pandemic is impacting rural obstetrics programs. MATERIALS AND METHODS: This qualitative study surveyed participants who worked in rural obstetrics programs in New Mexico using a free response questionnaire. RESULTS: The pandemic has changed the obstetrics experience in rural New Mexico by impacting the relationship between patients and providers and altering the family-centered model of birth. Difficulties unique to rural obstetrics included lack of transportation, limited hospital rooms and limited staff, including OB providers, nurses and housekeeping. Wellness has been impacted for providers, manifested in increased anxiety, stress and burnout. Patients reported increased anxiety, decreased family support, and potential disruptions in maternal-infant bonding. CONCLUSIONS: Rural hospitals and clinics in New Mexico and across the United States operate with challenges at baseline, with many clinics across the nation closing, leading to increasing shortages of healthcare services in rural areas. This study showed that COVID-19 has increased the challenges that rural obstetrics providers face, altering the way they practice and creating uncertainty for the future due to potentially permanent changes to their practice. Future research will explore the lasting effects of the pandemic on rural obstetrics providers specifically, and rural hospitals generally.