We Had to Take Extra Precautions — Shelby’s Story
We want the best health outcomes possible for all North Dakotans, and we believe when our neighbors share their stories with others, it helps all of us identify and address the barriers affecting our own communities. This is the story of Shelby Davis, who faced significant challenges when trying to access maternal healthcare during her high-risk pregnancy.
It was extremely difficult and scary to know that the resources needed for my pregnancy were not close by.
- Shelby Davis
Anyone who has experienced a pregnancy knows they come with a lot of doctor’s appointments … from tests and ultrasounds to an ever-increasing number of checkups as the baby’s due date nears. Plus, of course, postpartum care.
For many people living in larger cities across North Dakota, these appointments become routine … part of the day-to-day. They might occasionally interfere with family schedules or conflict with work obligations, but no more than is to be expected.
For people living in rural areas, however, this isn’t always the case. Many North Dakotans live in what are called “healthcare deserts,” which means they have to travel long distances to get the proper medical care they need. According to Harvard Medical School, approximately 77 percent of all rural counties in the United States fall under this definition due to a shortage of primary care professionals in their respective areas.
This disparity is even more pronounced when looking at maternal healthcare in particular. According to data compiled by March of Dimes, 32.6% of all counties in the U.S. are considered maternity care deserts … but in North Dakota specifically, this applies to a troubling 71.7% of counties.
Shelby Davis knows firsthand what it’s like living in one of these maternity care deserts. Due to previously diagnosed medical conditions, her pregnancy was considered high risk. Shelby needed specialized care — care she couldn't get in her small town. She ended up having to drive six hours to get the care she and her baby needed: three hours there, three hours back.
For every appointment.
“Unfortunately, there are limited resources in our area for a high-risk pregnancy, so I made these monthly and then weekly trips to receive the care needed,” Shelby told us, adding that the winter weather made the long drive challenging as her pregnancy progressed.
Thankfully, Shelby had a lot of experience with rural living, having lived in her small hometown all of her life, and was well-accustomed to traveling for quality medical care. During the course of her high-risk pregnancy, however, the stress of knowing her doctors were so far away started weighing on her and affecting her mental health.
“My biggest concern was that when or if an emergency happened, my provider was not nearby,” she said. “It was extremely difficult and scary to know that the resources needed for my pregnancy were not close by, but I continued to make that trip to receive the care needed for myself and my family.” Shelby had to use some of the leave she’d banked up and had been saving for after the baby was born to make some of these recurring, out-of-town appointments.
On the winter night that Shelby went into labor, she once again had to make the three-hour drive to her provider’s hospital. And she wasn’t alone: 9.7% of women across the U.S. have to travel more than 30 minutes to find a birthing hospital. In North Dakota, that rate is a staggering 43.8%.
Shelby told us the trip was worth it given the excellent care she received. Still, “It would have eased my stress level knowing that the care needed for my pregnancy was in my hometown instead of having to call my doctor, who was hours away from me.”
After giving birth, Shelby continued to travel the six hours to see her specialist for her postpartum care — a drive she now had to make with a newborn baby, which added to the already long and challenging trips. “They knew my medical history, so I was more comfortable doing all of my health care with the same doctor,” she said.
Improving access to quality medical care during the perinatal period is key to ensuring women like Shelby won’t always have to worry or stress during their pregnancies. At FHND, we’re hopeful that increasing telemedicine availability in rural and frontier communities as well as government incentives for doctors to live and practice in rural areas — including addressing pay differentials between rural and urban hospitals — will bring improvements to smaller towns across our state. To learn more about this work, check out the “Nowhere to Go” report from March of Dimes, which includes policy recommendations that include expanding Medicaid coverage for postpartum women. March of Dimes also provides additional information about maternity care deserts.
If she had to do it all over again, Shelby told us she would’ve done things exactly the same. That said, she would’ve chosen to give birth closer to home if given the chance.
“Overall, I felt it was worth traveling the six hours round trip to receive the care that I did. But it would’ve been nice to get that experience without having to drive the six-hour round trip.”
If you have a story about how an illness, disease, or any other health-related issue has impacted your life, we want to hear from you. Share your story with us here. It could help your neighbors — and create a healthier North Dakota for all of us.