When I began my medical education, I knew I wanted to work with rural communities like the ones in which I grew up. I spent most of my childhood between northeast Pennsylvania and my grandparent’s potato farming community in northern Maine. I wanted to help bridge gaps in access to high-quality care, such as when my grandparents traveled over six hours to get the right care for my grandfather’s lung mass. As I further explored medicine, I developed a passion for partnering with women to keep their lives as healthy and vibrant as possible. I looked for ways to combine my interests in rural care and women’s health. Through a mentor who spoke highly of her experience with Southcentral Foundation, I came across the Nuka System of Care Fellowship, which offered the opportunity to learn how a leading U.S. health care system bridges rural and urban maternal care in a culturally minded and relationship-centered way.
In my first months at SCF, I was able to visit an OB-GYN field clinic where I observed women with complex gynecologic needs cared for by specialists from SCF. The care extended beyond providing direct service, it also included listening to stories of how the care was directly impacting their lives. These conversations centered around supporting a woman’s ability to uphold her values and traditions, such as caring for others in the community or assisting with tasks after a successful hunt.
I was touched and inspired when one woman, radiating with pride, showed me pictures of her son and a caribou that she helped prepare — now without fear of incontinence.
As an improvement fellow, I have also had the opportunity to work with the multidisciplinary OB-GYN teams to identify ways to grow and improve the continuum of care between rural and urban clinical settings. As part of my experience, I supported several initiatives that focus on examining the ways to expand services and improve birth outcomes for rural customer-owners. For example, we are currently discussing best practices for communication when a transfer of care is needed between SCF and referral networks. The improvement methodology, such as developing specific and measurable goals, testing rapid cycles of change, and navigating through levels of resistance are skills I will integrate into my future career. I hope to continue efforts to improve the lives of the 18 million reproductive-age women who live in rural communities.
The partnerships I have observed are incredible examples of the waysrural-urban networks of maternal care can provide clinical support to low-volume areas. While essential for improving birth outcomes, I have learned over the last few months these networks require a considerable amount of time and resources to coordinate. I am beginning to appreciate the importance of documenting metrics and voicing stories that highlight the impact of these services, and I recognize the need for ongoing advocacy on a state and national level.