I was moved by the article "Why Are Women Still Dying of Pregnancy and Childbirth?" by Dalia Sofer (In the News, September). I have cared for high-risk obstetric patients in a city setting for 30 years, but never considered the hardships faced by patients in a rural setting. Since reading the article, I have learned that access to women's health care is an ongoing challenge in rural communities, such as those close to my home where there are counties without one obstetrician. I am writing to thank AJN for its attention to such an important issue and to challenge myself to become a part of the solution.

Lack of access to health care may be a root cause of the high incidence of maternal death in rural populations. According to the American College of Obstetricians and Gynecologists, more than half of rural women have to drive over 30 minutes for perinatal services at the nearest hospital.1 In these areas, access to health care is the first problem to solve. Additionally, addressing factors noted by Sofer, such as comorbidities, mental health issues, and racial bias, is imperative to reducing the risk of dying from childbirth in rural America. Obstetric nurses must mobilize to work toward a solution.

Lisa Rosindale, RN, RNC-OB

New Bern, NC

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