All expectant mothers hope for an uneventful pregnancy and a healthy birth, but things don’t always go according to plan. Montana has one of the highest maternal mortality rates in the country, underlining just how important it is for pregnant women, especially in rural areas, to keep up with regular prenatal care visits.

“We’re one of only two hospitals in southeast Montana that does obstetrics and deliveries, so it’s really about being able to provide care to patients who live in this area,” Jay Littlefield, MD, an OB/GYN with Holy Rosary Healthcare explained. “The biggest barrier they face is not being able to access care because of their physical location. Some patients I see commute anywhere from one to three hours and up to 150 miles to come to Miles City for appointments. By bringing these services to them, they are more likely to get the prenatal care they need.”

And for women facing high-risk pregnancies, Intermountain Health’s recently expanded Maternal Fetal Medicine (MFM) services are a lifeline.

Dr. Littlefield sees patients from across southeast Montana. In addition to caring for women in Miles City, he travels to Baker, Ekalaka and Forsyth to see patients at outreach clinics every other week and conducts virtual visits regularly.

With the new program, when Dr. Littlefield identifies patients who may be at risk for pregnancy complications, he is able to refer them quickly to an MFM specialist, like Michael Gordon, MD, at St. Vincent Healthcare in Billings, for a telehealth consultation or in-person appointment.

“There just aren’t any maternal fetal specialists in these rural areas,” Dr. Gordon noted. “Patients often cannot afford to travel, or they may not have anyone at home who can watch their other kids while they are away. For these reasons, some patients in underserved areas do not pursue any prenatal care until late into their second trimesters, if at all.”

Through this new program, Dr. Littlefield and Dr. Gordon hope to break down some of those access barriers for moms and babies in eastern Montana by providing care in their local communities. In addition to the increased access to specialized care, the MFM program also provides advanced training for sonographers in rural areas that allows them to perform Level II, high-risk ultrasounds at local healthcare facilities rather than requiring women to have to travel for additional tests and diagnosis.

Once a woman has been identified as having a high-risk pregnancy, the MFM specialists work closely with the patients’ local OB/GYNs to determine the most appropriate plan of care for her pregnancy, labor and delivery.

“I’m so glad we can offer this program to women in this part of the state,” Dr. Littlefield said. “It’s really creating a meaningful difference in patient care and outcomes.”

Signs of high-risk pregnancy

The most common factors that might put a patient at high risk of pregnancy complications include pre-existing medical conditions such as hypertension or diabetes; an adverse outcome during a prior pregnancy; carrying more than one fetus; and advanced maternal age.

“The best thing you can do to minimize your risk is begin taking prenatal vitamins before you even start trying to get pregnant,” says Dr. Jay Littlefield, OB/GYN. “Try to maintain a healthy diet and weight, work on controlling chronic conditions, and make sure that any medications you’re currently taking are safe to continue during pregnancy. These are the things that will be most beneficial.”

If you experience any of the following symptoms during pregnancy, call your doctor right away:

• Persistent pain in the chest or abdomen
• Dizziness, fainting or extreme nausea and vomiting
• Fever over 100.4
• Sudden or severe headache
• Heart palpitations and/or difficulty breathing
• Vaginal bleeding
• Decreased or no fetal movement

Learn more about Holy Rosary’s program and services at hrh-mt.org/baby or call 406-351-7660.

Learn more about St. Vincent’s program and services at svh.org/baby or call 406-237-7086.