Sustainable Postpartum Hemorrhage Training for Rural Obstetric Nurses in the Absence of Routine Patient Care Experiences.

Critical access birthing units are essential for the well-being of maternal and neonatal patients in rural areas; however, many rural hospitals are closing their birthing units due to a variety of complex factors, including the difficulty of maintaining highly trained staff. These closures worsen the already vast "maternity care deserts" found across much of the rural United States. Postpartum hemorrhage is one of the most common complications during childbirth, but nurses providing care at low-birth-volume hospitals in rural areas often lack routine exposure to postpartum hemorrhage and have limited opportunity to gain proficiency in postpartum hemorrhage prevention, identification, and management. Sustainable and accessible training modalities help to support rural obstetric nurses, sustain rural birthing units, and improve maternal and neonatal health outcomes.