Behind the scenes of rural maternal health care reporting in Nevada

The story was originally published by the KUNR with support from our 2023 National Fellowship.


KUNR’s Lucia Starbuck just wrapped up her four-part series about maternal health care deserts in rural Nevada and the role doulas can play. She sat down with Morning Edition host Lori Gilbert of KNCC, KUNR’s sister station, to pull back the curtain and chat about what went into this project.

LORI GILBERT: This is a broad topic, and I’m curious as to how the project came about and how you went about finding some subjects and people to talk to.

LUCIA STARBUCK: This [series] has really been my baby. The idea really started forming back in the spring. We got a press release from Nevada Medicaid saying, “Hey, we’re going to increase the Medicaid reimbursement rate for doulas if you make sure your client follows through on a dentist appointment,” I was like, “Okay, problem solved.” And then I talked to some doulas, and they’re like, that doesn’t quite meet the cost of living, but we’re working on this bill to triple that Medicaid reimbursement rate.

So I was following that during the legislative session and then seeing that March of Dimes report that said more than half of Nevada counties are considered maternal health care deserts. I was super curious about the role that doulas can play.

It’s been just a wonderful journey, letting health care researchers and health care organizations know I’m working on this project, and they’re pointing me to traveling providers. I also had a survey that I distributed online and at places like libraries and daycares in rural Nevada for expectant parents and people who have recently given birth to share their experiences with us.

GILBERT: Was there any event or person from the reporting that you were doing that really stood out for you?

Image of a person standing near table smiling

KUNR’s Lucia Starbuck tabling at the UNR School of Medicine Office of Statewide Initiative’s 2023 Nevada Rural EMS Conference in Elko, Nev., on Sept. 15, 2023.

Courtesy Of Lucia Starbuck

STARBUCK: One event that I really enjoyed was the rural EMS conference in Elko. A couple folks told me at the beginning of the project, “Hey, are you aware that rural EMS plays a role in maternal health care?” and that wasn’t really something that I had on my mind. So that really opened my eyes to kind of who is responding to these calls.

Meeting with the doulas was really cool. A lot of times, I would be in an interview or talking with a group of people, and it would actually be like all women in the room, and that was like really cool to see and be a part of and talk so vulnerably about issues impacting moms in rural Nevada.

Something that I also really enjoyed was our own event. We brought together three moms, two rural doulas, a rural doula in training, a rural midwife, and a community health organization. And we had a roundtable in Fallon to talk about the problems and the solutions they would like to see.

GILBERT: It sounds as though it really helped shape your perspective. What was that listening session like?

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KUNR’s Lucia Starbuck (back, left) at the rural maternal care roundtable event hosted by KUNR Public Radio and USC Annenberg Center for Health Journalism in Fallon, Nev., on Nov. 6, 2023.

Kat Fulwider/KUNR Public Radio

STARBUCK: I met this doula based in Fallon. After interviewing a couple of the moms that she worked with, a couple of moms did not have the pregnancy experience that they had hoped for. They asked me, “I don’t know if you’ve ever heard this before,” or, “I feel kind of alone.” And I took a second to say, “I’ve actually heard this from other people.” I was curious if there would be space for bringing people together in a room to say, you know, you’re not the only one who has had this experience in rural Nevada with a doula.

Another thing that I loved about this event, I asked everyone to bring their own question and pose it to the group. And the Fallon doula asked, “What can I do better?” And people had concrete advice for her.

GILBERT: You strike a common theme, you know, along this long road to maternal health care, and something we’re used to living in rural communities: it can be isolating. The doula provides this kind of relationship that someone would need, especially if you’re a first-time mom. What do you hope people will take away from listening to your four-part series?

STARBUCK: It’s really important for me for this to be documented. When I first started, I heard a million anecdotes but not a lot of news coverage. And, of course, I’m the politics reporter, so I hope it affects policy changes.

People told me they would like to see birth centers in rural Nevada. They just want to see a provider in their own community; they don’t want to travel. I heard a lot that there are low numbers of births and babies being born, so it doesn’t justify having these resources out there; however, there are still parents and families and people who are pregnant living in rural Nevada.

I really hope that lawmakers, especially our rural lawmakers, can pay attention to this.

GILBERT: This is just one snapshot as you focused on maternal health care. But throughout rural Nevada, Nevadans are traveling for other types of care.

A person interviewing someone

KUNR’s Lucia Starbuck (right) interviews Lora Redmon, Renown’s manager of nursing for labor and delivery, in Reno, Nev., on Oct. 18, 2023.

Kat Fulwider/KUNR Public Radio

STARBUCK: Yes, it’s not just maternal health care. It’s cardiology [and] optometry. Where are people getting cancer treatments? It’s primary care as well.

Something that I heard again and again is that rural community members are used to driving, and people kind of told me with a chuckle, but it made me very concerned. I was like, “How many miles are you adding to your car? Are you having to take time off work? Who’s watching your kids?”

I really want to continue reporting on different types of health care and health care gaps and where the resources are. If you’re affected by any of this, please don’t hesitate to reach out.