MaineHealth receives $667k grant to establish rural obstetric training
Against a national backdrop where hospitals are ending labor and delivery services, MaineHealth was awarded a three-year, $667,330 grant to establish new rural obstetric training programs.
The effort was established through the Maine Rural Graduate Medical Education Collaborative, or MERGE, which was created by MaineHealth, Northern Light Health, Central Maine Medical Center and the Maine-Dartmouth Family Medicine Residency to increase training opportunities for graduate medical students in rural communities.
“This grant will help address the need for more obstetrics-trained providers in our rural areas,” said Dr. Kalli Varaklis, MaineHealth’s designated institutional official and the principal investigator for the grant. “It creates an opportunity for students in rural residency rotations to learn important skills to support pregnant patients and their families.”
The money comes from the U.S. Department of Health and Human Services Health Resources and Services Administration.
The goal is to allow MERGE to develop obstetrics education programs focused on rural community needs.
Curriculum development
Physicians from six hospital programs in Maine and Eastern New Hampshire — including MaineHealth Stephens Hospital, MaineHealth Franklin Hospital, Northern Light Mayo Hospital, Mount Desert Island Hospital, Maine-Dartmouth Family Medicine Residency and MaineHealth Memorial Hospital — will develop the new curriculum.
Dr. Jeannette Andrews, an ob/gyn at MaineHealth Stephens Hospital, and Dr. Kathryn Hoffmann, a family medicine physician at Maine-Dartmouth Family Medicine Residency, will lead the effort.
“Family medicine physicians train to provide comprehensive health care across settings and over the lifespan, so they are well-positioned to help address the gap in obstetrical care within rural communities,” Hoffmann said. “Building strong partnerships between family medicine and ob/gyn physicians can increase access to specialty care in rural communities by allowing ob/gyn physicians to focus on higher risk patients and surgical procedures.”
The leaders will use focus groups to learn what skills patients feel residents need to learn most. Patient focus groups will begin in early 2025. The training is expected to open by the end of the year.
National trend
Obstetric units have been closing throughout the U.S. in recent decades, especially in rural areas, according to a needs assessment of the obstetric workforce in Maine’s rural hospitals, commissioned by MaineHealth to the Roux Institute at Northeastern University and published in January 2024.
By 2020, half of all U.S. counties lacked a hospital offering obstetric services.
The decline is particularly acute in rural areas, with 89 rural hospital obstetric units closing between 2015 and 2018.
Key reasons behind the closures include financial strain caused by Medicaid reimbursement rates inadequate to cover the total costs of obstetric care, challenges in recruiting and retaining medical staff and an overall decreasing volume of births.
Maine’s obstetric landscape “has experienced a significant transformation in recent decades,” the report said, with over a dozen obstetric units closed since 1970 and half of those closures occurring in the last decade.
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