In rural America, especially in areas like Baker City, Oregon, the closure of local maternity wards has intensified concerns about maternal health. For many young women, the most pressing issue isn’t access to abortion services, but the struggle to find adequate care during pregnancy and childbirth.
Shyanne McCoy, a 23-year-old Baker City resident, found herself facing a 45-mile drive over a mountain pass to the nearest hospital with an obstetrician during her pregnancy. When complications arose, McCoy had no choice but to travel two hours to Boise, Idaho, for specialized care. For a full week before her daughter’s birth, she stayed there, away from home, to ensure she had the medical support she needed.
Care for women during pregnancy and childbirth is essential to ensure the health and well-being of both mother and baby. This care includes a wide range of medical, emotional, and social support that starts early in pregnancy and extends through delivery and postpartum recovery.
During pregnancy, regular prenatal visits are critical for monitoring the health of the mother and fetus. These visits typically include routine screenings, blood tests, and ultrasounds to track the baby’s development and detect any potential complications, such as gestational diabetes, preeclampsia, or fetal growth restrictions. Healthcare providers offer guidance on nutrition, exercise, and lifestyle choices to support a healthy pregnancy. They also educate women on warning signs like excessive swelling or abdominal pain, ensuring they know when to seek immediate medical attention.
Labor and childbirth are significant events that require careful planning and skilled care. Women can choose different birth settings, including hospitals, birth centers, or home births, depending on their health and preferences. In a hospital setting, women are typically supported by a team of professionals, including obstetricians, midwives, and nurses, who provide pain management, assist with labor progress, and monitor both the mother and baby throughout delivery.
In addition to physical care, emotional support is equally vital. Having a trusted birth companion, whether a partner, doula, or family member, can reduce anxiety and enhance the birth experience. After childbirth, postpartum care focuses on the mother’s physical recovery, mental health, and breastfeeding support.
In rural or underserved areas, access to comprehensive maternity care can be a challenge, underscoring the need for better healthcare infrastructure to ensure all women receive the necessary care during pregnancy and childbirth for a safe and positive experience.
McCoy’s experience highlights a growing trend in rural areas across the country: the lack of maternal health care is becoming the primary concern for women. According to a study published in JAMA, more than 50% of rural hospitals have eliminated obstetrics services, leaving women with limited options for safe and accessible pregnancy care.
In Oregon, while the state is one of the most protective in terms of abortion access, rural communities are voicing strong opposition to expanding abortion services before improving maternal health care. A recent proposal for mobile reproductive health clinics in rural areas — including abortion services — was met with resistance.
Paige Witham, a member of the Baker County health care steering committee, expressed that expanding abortion services before addressing the community’s need for better maternal health care could create significant backlash. “Before we talk about abortion services, we need to ensure that young families in rural areas have access to quality pregnancy care,” said Witham, who is also a mother of two.
A mobile clinic that could deliver services such as birth control and educational resources is viewed favorably by some, including Kelle Osborn, a nurse supervisor at the Baker County Health Department. However, the inclusion of abortion services in such a clinic could deter many from seeking help, fearing social stigma in this tight-knit, conservative community.
The impact of the maternity care crisis in rural America cannot be overstated. Research shows that the further women must travel for care, the greater the likelihood of complications. Babies born far from specialized obstetric care are more likely to need neonatal intensive care, adding to the emotional and financial strain on families already facing limited resources.
Although some residents express personal opposition to abortion, most agree that the government must provide better support for young families — including free child care and improved mental health services. Without such improvements, many argue, access to abortion should remain a legal option.
The situation is more than a political debate; it’s about the real health care needs of rural families. With nearly half of rural counties classified as “maternity care deserts,” many women must drive over half an hour to reach obstetric care, with some in Southern states facing abortion access up to 700 miles away.
For rural doctors like Nathan Defrees, providing basic health care in areas with limited resources can be challenging. While Defrees doesn’t perform abortions, he helps patients navigate their options. “It’s not just about abortion,” he said. “Women here need more access to general health care and maternity services.”
The situation in Baker City mirrors a broader national trend, where rural women, particularly in conservative areas, are seeking improved maternity care over abortion access. As rural communities continue to struggle with healthcare gaps, the need for more comprehensive solutions — from maternal health to reproductive rights — is undeniable.
For these rural residents, the conversation is no longer just about abortion — it’s about ensuring that every woman has the ability to receive the care she needs to have a healthy pregnancy and a healthy baby.
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