Mothers in a Rural Community: Women's Lived Experiences and Implications for Rural Social Work

Background and Purpose

Geographic barriers and shortages in healthcare professionals have been well documented in rural America; however, rural women’s perspectives about these realities have been overlooked. Without greater awareness of rural realities, we are apt to rely on a stereotype of rural women that is inaccurate. As Kenkel (2003) writes, “by identifying concepts important to different cultural groups and to the silencedrural women, culturally sensitive prevention and treatment services can be designed” (p. 189).

The purpose of this study was to conduct 24 semi-structured interviews with rural mothers utilizing WIC in a North Dakota county. As they sought healthcare associated with their pregnancy and delivery, we asked about their perception of geographic barriers to healthcare, rural parenting, and their specific rural community.

Method

With a philosophical stance of pragmatism, we sought to consider the potential connections between these mothers’ experiences and “the outcomes of the research—the actions, situations, and consequences of inquiry” (Creswell, 2007, p. 22). Our research questions were formed with the assumption that women’s responses could be used to improve various healthcare and social services provided to them. Our inquiry was also consistent with the aims of phenomenological inquiry. We sought (1) meanings behind human experiences, (2) made efforts not to predict or determine causality, and (3) described experiences rather than using measurements or ratings (Moustakas, 1994). Thematic analysis was utilized to identify core ideas and unified impressions that emerged from the women’s interviews. First, we began with line-by-line coding from the complete transcripts. After initial line-by-line coding, we grouped codes into larger thematic categories, or axial codes, representing common themes that emerged from the interviews.

Participating mothers were on average 24 years of age with ages ranging from 18 and 32. Approximately 70% of the mothers identified as White (N=17), while one-quarter of mothers (N=6) identified as Mexican-American. One mother (4%) identified as Native American. Fifteen (63%) of the mothers were married, and nine (38%) were single.

Findings

The thematic categories best reflecting our interviews include: 1) the minimization of geographic barriers to care; the 2) challenge of obtaining rural childcare; and the 3) cost and benefit of rural parenting. First, mothers voiced a psychological minimization of geographic barriers to maternity services.  Second, women experienced significant challenges accessing rural childcare including financial burden and scheduling difficulties. Third, mothers identified safety as a benefit of parenting in their community.

Conclusion and Implications:

Although our qualitative inquiry cannot be generalized to other rural populations, qualitative methods can improve social work services directed at maternal and child health in rural areas. Culturally competent social work practice requires an understanding of a rural worldview so it can be both relevant and adaptable to the realities of rural living. Our work also demonstrates that rural residents see their community beyond merely a deficit-based perspective. Rural community strengths and capacities should be more strongly understood by social work practitioners serving its residents.