How Connected Care Networks Are Strengthening Rural Maternal Care

When the American Hospital Association launched the Keeping Care Close to Home: Innovations in Rural Maternal Health project in 2025, we set out to understand how rural hospitals and health systems are drawing on the assets around them to strengthen maternal health services and help keep care within communities.

Through conversations with rural hospital and health system leaders across the country, a key theme emerged: Connection is essential to sustaining rural maternal care. Rural hospitals are developing trusted relationships, infrastructure and networks that connect maternal health clinicians and patients with specialized clinical expertise, workforce support, technology and other resources. Through these connections, hospitals can expand the maternal health services they provide locally while helping patients access higher levels of care when needed. 

Avera Health, Dartmouth Health, Banner Health and Rochester Regional Health demonstrate what connected maternal care networks look like in practice. 

Extending Specialty Expertise Into Rural Communities with Technology 

Across South Dakota-based Avera Health’s vast rural footprint, the health system has brought specialty care to patients in their local settings whenever it is safe and appropriate to do so.

Though this work began more than a decade ago, today Avera Health uses telehealth to bring specialists into rural communities virtually, including tele-ultrasound to extend access to maternal-fetal medicine expertise, remote monitoring to stay connected with patients at home, and a centralized virtual obstetric nursing hub to provide local teams with additional clinical support.

But the goal is not simply to connect patients with specialists. The aim is also to strengthen the capabilities and confidence of local teams so they can provide more care in their own communities. Kimberlee McKay, M.D., OB-GYN and medical research director for the Avera Research Institute, says the health system’s thinking has shifted “[to] enable the local teams to also care for the patient and feel comfortable with it.”

For Avera Health, technology is the connective tissue that makes this model possible — extending specialty expertise to the bedside, strengthening local teams and helping more patients receive the care they need without having to travel long distances.

Supporting Rural Hospitals Through Trusted Partnerships 

Strong regional networks are rooted in relationships. Dartmouth Health works with rural hospitals across northern New England, both within and outside its health system, through consultation, workforce development, shared clinical guidance and quality improvement. The goal is to help rural clinicians and hospitals strengthen the services they provide in their own communities.

Kevin Curtis, M.D., medical director of Connected Care at Dartmouth Health, described that philosophy simply: “When you connect, you’re walking into the room asking, ‘How can I help?’ It’s relational and service oriented. Whatever you need, how can I possibly deliver on it?”

That collaborative mindset helps build trusted relationships between the academic medical center and its rural partners. Through ongoing consultation, education and cooperation, rural clinicians develop connections with partners they can turn to when a complex case or emergency arises. Kate Stokes, a certified nurse-midwife at Dartmouth Health, noted that mutual trust was of paramount importance between rural clinicians and consulting specialists. When specialists respect local clinicians’ expertise and understand the realities of practicing with limited resources, rural clinicians may feel more comfortable reaching out for consultation. Over time, these relationships create a network of support that strengthens clinicians’ ability to provide care close to home.

Building One Connected Health System 

Banner Health strengthens rural maternal care by leveraging resources throughout the system. Across the six-state network, rural clinicians participate in shared leadership collaboratives, standardized clinical protocols, simulation training, tele-obstetric consultation and rotations through higher-volume centers. Rather than asking each hospital to independently build every capability, the system shares expertise and infrastructure across sites.

This approach can reduce professional isolation, strengthen clinical readiness and give rural teams access to resources that may not be feasible to maintain at individual hospitals.

For Blake McLaughlin, D.O., senior medical director of women’s health services at Banner Health, the model begins with culture. “The rural communities that we serve, they’re not problems to be fixed. They are real people, real communities. It is us. And we really approach it from our cultural anchor point, which is one team,” McLaughlin said.

Standardizing Care Across a Regional Network 

Rochester Regional Health is helping ensure patients receive consistent, evidence-based maternal care regardless of where they live or enter the health system through their Women’s Health System Council. The council aligns protocols, workforce training and quality improvement initiatives across hospitals and ambulatory settings. 

Elizabeth Bostock, M.D., an OB-GYN and former executive medical director at Rochester Regional, said the system’s goal is to provide patients access to prenatal and inpatient care across the system and be able to respond to emergencies in remote rural communities such as hemorrhage, shoulder dystocia and hypertensive crises.

Achieving the goal requires creating a structure for clinicians to learn from one another.

“Consistency and conversation,” Bostock said. “Continue to invite people to the table.”

That ongoing collaboration has helped build a culture of shared learning across the system. Rochester Regional Health reports that its cesarean delivery rate declined from more than 40% to approximately 27%, while shared protocols and quality improvement efforts have supported greater consistency across care settings.

Building the Future Together 

Keeping maternal care within communities does not mean rural hospitals have to do it alone. When hospitals, health systems, clinicians, community partners and other organizations come together, they can strengthen local care and expand what is possible for rural communities.

The stories highlighted here are just a few examples of how rural hospitals and health systems are putting this approach into practice. Our rural maternal health podcast series, Frontiers, explores more of these stories, featuring hospital leaders and providers working every day to sustain and strengthen maternal care across rural America. Listen to episodes, Committing to Rural Maternal Care, The People Powering Rural Maternal Care and Connected Rural Maternal Care, Closer to Home on the AHA’s Advancing Health podcast channel or wherever you get your podcasts.

The future of rural maternal care will not be built by rural hospitals alone. It will take the strength of the broader healthcare system — connecting expertise, people and resources across communities and organizations — to ensure rural families can access the care they need, close to home.

Visit aha.org/ruralmaternal to stay engaged as we share additional podcast episodes, resources and lessons learned from rural hospitals and health systems across the country.