Salud Rural Maternal Child Health Fellowship

Barriers to maternity care can delay or prevent access to prenatal, delivery, and emergency services, increasing the risk of complications, preterm birth, maternal and infant mortality, and other poor health outcomes. These challenges disproportionately affect rural, low-income, and underserved communities, further widening existing health disparities. As rural hospitals close maternity units and fewer physicians provide obstetrical care, many pregnant patients must travel longer distances for care while providers often serve multiple communities to meet growing demand.

Dr. Theresa Whitchurch, Associate Program Director for the Sollus Northwest Family Medicine Residency, saw these consequences firsthand while training at a rural hospital.

A pregnant patient arrived with a ruptured uterus. An emergency cesarean section was needed to save the baby, but the provider on site did not perform C-sections and the surgical provider was about 30 minutes away.

"We had to wait," said Dr. Whitchurch. "By the time they got there the baby had passed away."

The experience stayed with her. It underscored how critical advanced maternity skills can be in rural communities where specialty care may not be immediately available. It also influenced her decision to pursue the Salud Rural Maternal Child Health Fellowship.

Created in 2019, the fellowship helps address growing workforce challenges in rural maternal health by preparing family physicians to provide a broader range of care in the communities they serve. The one-year program offers rural providers advanced training in obstetrics, cesarean sections, newborn resuscitation, women's health procedures, and the management of high-risk pregnancies.

The advanced skills Dr. Whitchurch gained during her fellowship prepared her to care for patients with complex pregnancies in the rural communities she serves. Today, she provides prenatal care, delivers babies, performs cesarean sections when needed, and continues caring for both mother and child after delivery.

For one patient, that continuity of care made a meaningful difference. During a labor that ultimately required a cesarean section, the patient was relieved to learn she could remain with the physician who had cared for her throughout her pregnancy rather than being transferred to another provider.

"She asked me, 'Are you going to do my surgery?' and I said, 'Yes,'" said Dr. Whitchurch. "She just seemed so relieved. I would never have been able to do that without the additional training."

That continuity benefits patients by providing them with a physician who knows their medical history and can care for both parent and child through pregnancy, delivery, and beyond.

Through the Salud Rural Maternal Child Health Fellowship, physicians like Dr. Whitchurch are gaining the skills to care for mothers and babies throughout pregnancy and delivery. For families, that can mean receiving care from a trusted physician before, during, and after birth. For rural communities, it helps strengthen access to maternity care at a time when those services are becoming increasingly difficult to find.