Roadside babies, dangerous births part of risk in small town Nebraska

Jasmine Gutschow felt nauseous when she woke up a few days before Thanksgiving last year. She brushed it off as typical pregnancy symptoms. She told her fiance he should head into work – the baby, not due for six more weeks, wouldn't be coming anytime soon.

Three hours later, after her contractions started, after they sped for the hospital, after their 2003 Chevy Tahoe broke down, after her contractions quickened to every two minutes and Gutschow's fiance frantically dialed 911, it had become crystal clear that this baby had other ideas.

Gutschow sat curled in the passenger seat on the shoulder of Highway 10 near Upland, trying not to scream in pain and scare the two other children in the car – there had been no time to find a babysitter.

"I really don't want to have this baby on the side of the road," Gutschow said as she told Gregory to call an ambulance.

The car problem: A faulty fuel pump.

The bigger problem: The couple lives 50 miles, and an hour's drive, from the hospital where Gutschow receives maternity care.

The couple lives in Franklin, in a county of 2,889 residents in south-central Nebraska. Like 55 other counties in the state, Franklin County has no hospital offering birthing services.

The long drive can lead to far worse outcomes than added mileage. Rural regions of the state accounted for roughly 40% of births from 2016 to 2018. During that time, rural Nebraska had a rate of roughly 52 severe maternal mortality cases per 10,000 deliveries, notably higher than the urban rate of 45, says the Nebraska Department of Health and Human Services.

And access to pregnancy care is getting worse.

Since 2017, Nebraska has lost six birthing units in rural hospitals already 35 miles away from the nearest hospital, said Sydnie Carraher of the Nebraska Perinatal Quality Improvement Collaborative.

As delivery rooms dwindle, emergency calls from expectant parents have become more frequent, said EMT Elizabeth Burki, one of the Hildreth first responders who answered Gutschow's call.

"The help is not there," Burki said.

When the ambulance arrived, Gutschow struggled to uncurl her body and lay flat on the stretcher. Her fiance and the kids stayed on the side of the highway as the ambulance pulled away.

One EMT called Gutschow's obstetrician. Another reassured her they had trained for this exact scenario. In fact, the Hildreth first responders had done a Simulation in Motion Nebraska training – a simulated emergency delivery – less than 48 hours before Gutschow's call.