Proximity to Care and Community: Rural Maternal Health Determinants in Georgia

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Abstract or Description

Georgia has among the highest maternal mortality rates in the nation. Among the social determinants of health that have an impact on this rate, two of the most significant are proximity to care and connection to community in rural areas. Large regions of Georgia have no hospitals, providers, or public transportation. The purpose of this inquiry is to explore the impacts of rural residence on maternal health experiences in Georgia.

The Georgia Moms Project collects ethnographic interviews with mothers who have
given birth in Georgia since the Affordable Care Act passed (2009). Pilot data include 37 interviews conducted with women recruited through social media and through safety net clinics in the Savannah area. These data are subjected to thematic and other qualitative analyses to examine trends in the experience of mothers in Georgia.

Results: Interviews indicate that women who live in rural areas of Georgia report difficulty accessing care due to distance, especially if a specialist is required. In addition, they report feelings of isolation and disconnectedness and a need for additional emotional and medical support throughout their care, especially during the postpartum year.

Conclusions: Results suggest that the types of isolation associated with rurality are a major precursor to feelings of loneliness that impede maternal well-being. Depression and anxiety resulting from isolation are perinatal mood disorders that can be connected to pregnancy-associated deaths. Steps must be taken to connect rural women to one another and to care providers, especially during the postpartum year.

Additional Information

Georgia Southern University faculty member, Heidi Altman, Stacy Smallwood, and Nandi Marshall co-presented Proximity to Care and Community: Rural Maternal Health Determinants in Georgia in the American Public Health Association Annual Meeting, November 2022.


American Public Health Association Annual Meeting


Boston, MA