Birth Outcomes Related to Distance in Rural and Frontier Kansas

Birth Outcomes Related to Distance




birth outcomes, distance traveled, rural Kansas


Introduction. Women from rural communities must travel greater distances to secure obstetrical care. This study sought the extent to which distance traveled by mothers for obstetrical services affects birth outcomes in rural and frontier counties of Kansas.

Methods. Medical students invited women over the age of 18 to participate in a recall survey regarding their children under three years old. Participants were a sample of convenience, and the length of data collection was a month. A bivariate analysis was performed on the responses gathered regarding obstetrical measures as a function of self-reported distance traveled to the hospital of delivery.

Results. Eighty-five women completed the survey, but only 76 satisfied all eligibility requirements. No statistical difference in birth outcomes were found between women who travel more than or less than 20 miles. However, when correlating data to that of the Kansas Hospital Association and the Kansas Department of Health and Environment, counties without birth facilities had a higher percentage of very low birth weights (< 1,500 grams) and more babies born at full-term when compared to counties that offer birth facilities. Babies born to mothers who reside in counties with obstetrical services were born at an earlier gestational age than those without birth facilities. Lastly, babies born into a family with income less than $50,000 weighed less and had a shorter gestational age than those from a more affluent household.

Conclusions. The results revealed counterintuitive findings that deserve to be explored further by a study with greater statistical power.


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Author Biographies

Janet A. Montelongo, University of Kansas Medical Center

Janet Montelongo, B.A.

Third-Year Medical Student

University of Kansas Medical Center

Joel Hake, M.D., University of Kansas Medical Center

Joel Hake, MD

Department of Family Medicine

Assistant Professor

Associate Program Director of Family Medicine Residency Program

Bruce S. Liese, Ph.D., University of Kansas Medical Center

Bruce S. Liese, PhD, ABPP is a Professor of Family Medicine and Psychiatry at the University of Kansas (KU) Medical Center and Clinical Director at the Cofrin Logan Center for Addiction Research and Treatment at KU. He has taught more than 100 courses and workshops on addictive behaviors, psychotherapy, and evidence-based practice, and supervised hundreds of psychotherapy trainees. Dr. Liese has more than 75 publications, and he has co-authored three texts on addictions. His most recent text, Cognitive-Behavioral Therapy of Addictive Disorders, was just published with co-author Dr. Aaron T. Beck. Dr. Liese received a President’s Citation for his work in Division 50 of the American Psychological Association (APA). He also received the Distinguished Career Contributions to Education and Training award from Division 50, and an APA Presidential Citation for his community service in 2018. In addition to his scholarly activities, Dr. Liese continues to see approximately 25 patients weekly.

Michael Kennedy, M.D., University of Kansas Medical Center

Michael L Kennedy, MD, FAAFP

Emeritus Professor of Family Medicine and Community Health

Dr. Kennedy was raised in Kansas. He attended medical school and completed his residency in 1993 at the University of Kansas School of Medicine, Kansas City. He practiced full spectrum Family Medicine (including OB and ER) in rural Kansas for nine years in Burlington, a town of 2,800. In 2002, he returned to KUMC in Kansas City to accept a faculty position in the Department of Family Medicine and Community Health ultimately gaining the rank of Professor and is an award-winning educator. He was the inaugural recipient of the Joy McCann Professorship in Rural Health. He served as the Associate Dean for Rural Health Education in the School of Medicine for 16 years. KUMC-SOM is nationally recognized for its long-standing reputation of rural programming. They have been in the top decile in the nation for the number of graduates practicing family medicine and choosing to practice in rural locations.

His primary interest during his career was access to care and health equity in rural areas. He served as the Director of the Office of Rural Medical Education and the Medical Director of the Institute for Community Engagement. He has worked with students to publish on the subjects of medical education, rural medicine, and access to maternity care in rural areas.

He has been involved in rural physician workforce issues in Kansas for 25 years. He was very involved in the Kansas Academy of Family Physicians over 25 years and served as President in 2007-08. He has worked with the Kansas Department of Health and Environment on several health care initiatives and nationally has served with the Congress of Delegates for the American Academy of Family Physicians and as a member of the Rural Health Congress for the National Rural Health Association. He was the founding President for the Kansas Rural Health Association.




How to Cite

Montelongo, J. A., Hake, J. ., Liese, B. S. ., & Kennedy, M. . (2022). Birth Outcomes Related to Distance in Rural and Frontier Kansas: Birth Outcomes Related to Distance. Kansas Journal of Medicine, 15(3), 319–324.



Original Research