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What Works? A Peek into Vermont’s Model of Maternity Care BY O.M. CAMPBELL
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n a recent United Health Foundation report, Vermont was named the third healthiest state overall in the country. Since the creation of the report in 1990, Vermont has risen 17 places. It enjoys a low percentage of uninsured people (3.8 percent) and was ranked second in women and children’s health. Vermont’s women are especially healthy. At 61 percent, they self-reported the highest rate of “high health status” in the U.S. Babies are doing well here, too. Vermont boasts some of the lowest infant mortality and childhood poverty rates in the nation. It is consistently ranked by Wallethub as one of the best states in the U.S. to have a baby. In fact, 2017 was the second year in a row Vermont
earned the number one slot. It made the top five on measures of most midwives, OB/GYNs, pediatricians, family doctors, and child care centers per capita. One of the big hurdles to providing high-quality in rural areas is lack of health care professionals interested in working there. So how does a predominantly rural state like Vermont attract such an amazing density of health care workers? “Vermont is a wonderful place to practice medicine. The medical community … is very collegial, so it’s an inviting place to work,” said Dr. Anna Benvenuto, medical director of specialty services in the women’s health department at the University of Vermont’s Porter Medical Center in Middlebury. “The ability to create longterm relationships with families across generations is a unique and enriching experience.” What’s more, she says the “availability of a multitude of outdoor activities, vibrant arts scene, and ability to be
socially engaged offers a wide range of opportunities outside of work. There is an ability to create a manageable worklife balance.” So is there anything we can glean from Vermont’s maternity care-delivery model that might help other rural states? Benvenuto says there are a few things that really elevate the state’s care. First is the Northern New England Perinatal Quality Improvement Network, a collaborative of hospitals and homebirth midwives throughout Vermont and New Hampshire that creates protocols for pregnancy and delivery care, holds educational conferences for care providers three times a year, and performs case reviews. Currently, 25 states have active perinatal quality collaboratives, with many others in the works. States with PQCs have seen significant improvements in the care of mothers and newborns. PQCs goals include reducing newborn infections, neonatal abstinence syndrome, elective early deliveries, maternal hemorrhage and hypertension,
Despite being one of the most rural states in the country, Vermont continues to be one of the nation's healthiest states. In RHQ's 2017 Rural Health Report Card, Vermont earned an A+ and ranked second in the nation for overall rural health.
SUMMER 2018 | RHQ 15