Nursing NEED ASSIGNMENT BY 8/21/2025 AT 7PM. MUST FOLLOW ALL INSTRUCTIONS. NO PLAGARISM

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Perinatal Healthcare in Your Community, Your State

Your Name

Frontier Nursing University

NM700-Role of the Nurse Midwife

Faculty Name

Date

*change all italicized, blue content to YOUR content in black ink, non-italicized and in Times New Roman***

PART 1: Community Description and Structural Determinants of Health for (insert your community’s name in black)

Community Description and Structural Determinants of Health for (your county name)

Instructions: Answer each question in the white boxes. Use your own words and provide links to your sources for each response. You may answer in bullet lists.

Community Intro

1. Where is your community located? What is the population?

2. What is your county's racial and cultural makeup by percent of the population?

3. Compare your county's median household income, poverty level, and unemployment rate to the state and the nation.

4. Briefly summarize any important findings from your Community Health Assessment in PC701. If you have not completed PC701, please explain this in the blank below.

Access to Perinatal and Reproductive Health Services

5. Is midwifery care available? If so, specify the type of care (AP, IP, PP, GYN & reproductive care). What kinds of midwives are available (CNM, CPM, CM). If not available, where is the nearest midwifery care? Is this a viable option for people in your community?

6. Is abortion care available in this community? What are the obstacles to accessing abortion care? (Distance, money, parental consent laws, mandatory wait times, etc). If abortion care is not available, where is the nearest abortion care?

7. Are perinatal and gynecologic health practices openly welcoming of individuals who identify as LBGTQ+? (hint: They can only be considered welcoming if people know they are--so how would people know? Do they support the LGBTQ+ community on their website, social media, or other public communication?)

8. Are fertility services available? What are the obstacles to access? (Distance, money, parental consent laws, embryo personhood laws, etc)

9. Are there free family planning, gynecologic, or prenatal care services for individuals who can’t access insurance, and where are these services located? (undocumented immigrants, those who can’t afford insurance)

10. Are there practices that offer CenteringPregnancy or another form of group prenatal care?

11 . What is the cesarean rate in your county? ( https://www.usnews.com/news/healthiest-communities/articles/2019-10-07/whats-my-community-c-section-rate ) Are vaginal birth after cesarean services available?

Birth Options in the Community

12. Provide the number of resident births in your county (this is the number of births to people who live in the county, no matter where they give birth)

13. Which birth settings are available in your community? (home, hospital, freestanding birth center)

14. Which kinds of birth care providers are available in your community? (physician, CNM/CM, CPM, etc)

15 . Where are the nearest maternal-fetal medicine physician and level 3 nursery? How far away? Does this represent a hardship for those who need this care?

16. What percentage of births are attended by midwives in your county? If county data is not available, provide state data.

15. What percentage of births are reimbursed by Medicaid in your community? (This may only be available for your state).

16. What percentage of Medicaid reimbursement do CNMs/CMs receive compared to physicians? (i.e., are midwives reimbursed the same [100%] as OB/GYNs in your state). This is often called Medicaid parity.

Local Transportation

17. What are the options for local transportation, and can people access healthcare facilities through public transportation? Buses, Trains, Subways, Taxi, Uber, etc.

18. Are there any discount programs for low-income women/pregnant individuals to access transportation to health care visits? (Does Medicaid cover transportation in your area?)

19. What are the transportation challenges that may impact access to care? Does public transportation service most residential and medical areas? Could transportation be a barrier to care?

Access to Care

20. Did your state participate in the Federal Medicaid Expansion under the Affordable Care Act?

21. What insurance options are available to immigrants with and without legal status in your state?

22. When and how can people access the healthcare.gov marketplace or your state marketplace for lower-cost insurance options?

23. What is the rate of uninsured people in your state or county? How does this affect the healthcare facilities and the individuals in your community?

When you have completed this section, re-read it and ensure that you have found and highlighted the challenges your community might face in accessing care. Our goal is to find the problems so we can address them.

PART 2: Perinatal Health Data Tables for (insert your community’s name in black)

Table 1. Perinatal Health Indicator Data for County Name, State Name, and the U.S.:

Health Measure	Your County	Your State	National data	*Healthy People (HP) 2030* Baseline**	HP 2030 Goals
Maternal Mortality rate per 100,000 live births	*	18.1a	16.9a	17.4b	15.7b
Early and Adequate Prenatal Care
Infant Mortality Rate per 1000 live births
Prematurity%
Low Birth Weight %				N/A	N/A

Key

These are examples; please delete them and include your APA references here

*Unable to find MMR for _______ County despite searching _____________

a(American Health Rankings, 2020). Data for maternal deaths in 2013-2017.

b (Office of Disease Prevention and Health Promotion. (ODPHP), n.d-a. Data for 2017)

Local Perinatal Health Disparity

Table 2. Perinatal Health Disparity for County Name, Year

Choose a social demographic factor, location/year, and Perinatal Health indicator.

· Social demographic factors include: maternal race, age, education, financial status, marital status, pre-gestation obesity, tobacco use

· Perinatal Health Indicators include: Infant mortality, Preterm birth, Low birth weight, and early and adequate prenatal care. Don’t use maternal mortality rate.

· You may need to compare many variables to find a disparity, and we encourage you to compare many and find the most interesting or significant disparity

· You may need to use comparison data at the state level if county-level data is not available. Data may be available from March of Dimes Peristats, CDC Wonder, or state health department data.

· Delete the blue text and enter your information in black

*Health Disparity Table for _____ County, State*
*Maternal Race/Ethnicity*	*Infant Mortality per 1,000 Live Births*
White
Black
Native Am./AL Native
Asian/Pacific Islander
Hispanic

(Source, Date) Data for 20XX

Table 3: Social Service Resources for Pregnant Individuals in County Name

Complete resources and services tables. Add rows as needed. Include at least 3 services or resources for each table. If you cannot find services in your community, list the closest resources your community must reach for services and the estimated distance. You do not need an in-text citation for the information in these tables - the local contact information, including the website, if applicable, will suffice. Address the following types of services and resources.

Social Service	Service Provided	Eligibility requirements	Location/contact information
WIC
Home Health Services if available

Table 4: Homeless Shelters in County Name

Homeless shelters	Service Provided	Eligibility requirements	Location/contact information

Response

Considering what you've learned, respond to these questions in 1-2 paragraphs:

1. Based on the data you collected, what is the most concerning indicator from Table 1 in your population? Why?

2. What did you learn when comparing different demographic groups in your community in your disparity table (Table 2)? Why did you choose this disparity?

3. Looking at the data and considering the information you gathered from your community assessment in PC701 and this assignment, what social and/or structural factors may contribute to the disparities or poor outcomes in your community?