Cambridge Festival Lecture: Factors that Impact Birthing Choice in Rural Appalachia

Growing up in Blowing Rock, North Carolina, a rural Appalachian town with a population of just over 1,300, Health, Medicine, and Society, MPhil student Caroline Hoover saw firsthand how social issues like health care access disproportionately affected her community.

After witnessing the reverberations of the closure of the local hospital in the horrifying experiences of neighbors, friends, and family members, she started seeking answers about the limitations of rural health care by leading a research team with the Office of Rural Health in the NC Department of Health and Human Services.

This research gave way to a specific focus on women's experiences making birth decisions in a geographically, economically, and resource limited environment. Utilizing semi-structured interviews, this research tells the complex story of the way women in an often misunderstood region, affected by cyclical poverty, endemic opioid addiction, and rampant hospital closure, make health decisions for themselves and their families. Many women experience reservations both about hospital birth, often stemming from medical mistrust and concerns about cost, and about home birth, given North Carolina’s extensive legal barriers to having one.

This has been further exacerbated by the catastrophic flooding as a result of Hurricane Helene, an event that has further constricted already limited health care resources.
In a county with a median income of $19,820, one medical center, and patients considered to be ‘high-risk’ being sent for care to the closest hospital two driving hours away, birth planning and decision-making is far from straightforward.

Amplifying these women's stories and the barriers they face in seeking responsible health care alllows for a fuller understanding of the hospital closure accelerated decay of the rural health care infrastructure in the United States. By highlighting the US health care system's shortcomings for its most vulnerable populations, this speech seeks to bring forth the ways in which a path forward towards a equitable health future for all can be charted.

Talk by Caroline Hoover.

Booking is not required. Free - drop in.