A groundbreaking new report by March of Dimes has highlighted a troubling health crisis affecting millions of women across the United States. The report reveals that more than a third of US counties, amounting to 1,104 regions, are classified as “maternity care deserts,” with no available birthing facilities or obstetric services. This alarming trend poses significant risks to the health and well-being of women and newborns in these areas.
Widespread Maternity Care Deserts: According to the report, 35.1% of US counties lack essential maternity services. These regions, home to over 2.3 million women of reproductive age, saw more than 150,000 births in 2022 alone.
Increased Health Risks: Women residing in these care deserts face elevated health risks, including poorer pre-pregnancy health, reduced access to prenatal care, and a 13% higher likelihood of preterm births.
Geographic Disparities: The states most severely impacted include North Dakota, South Dakota, Oklahoma, Missouri, Nebraska, and Arkansas. Approximately 60% of these maternity care deserts are in rural areas, while nearly 70% of birth centers are concentrated in just 10 states.
Decline in Maternity Care Facilities: The report highlights a troubling trend of hospital obstetric unit closures across the country. Since 2022, over 100 counties have experienced a reduction in maternity care facilities, with one in every 25 obstetric units shutting down. This has led to fewer options for families, increased stress, and longer travel times for expectant mothers.
Impact of Policy Changes: The reversal of Roe v. Wade by the US Supreme Court in 2022, combined with low health insurance reimbursement rates and payment structure issues, has exacerbated the decline in OB-GYN services. Additionally, restrictive abortion laws have contributed to a decrease in the OB-GYN workforce and a reduction in applications for obstetric residencies, further straining the system.
Rising Demand for Alternative Care: Despite the challenges, the report notes a modest increase in the use of birth centers from 2017 to 2022. Birth centers, which offer midwifery and wellness care but are not hospitals, are seen as a valuable alternative. However, with only 417 licensed birth centers across 270 counties and less than 5% located in rural areas, these facilities remain limited in their ability to meet the growing demand.
Kali Bautista, a resident of Brownfield, Texas, shared her concerns with the researchers, expressing her fear of delivering while en route to a hospital located 45 minutes away. She chose to receive care at a local birth center instead, highlighting the critical need for more accessible maternity care options.
Call to Action: Dr. Amanda Williams, Chief Medical Officer at March of Dimes, emphasized the urgent need for systemic change. “For too many families in the US, the ability to have a healthy pregnancy is contingent on their location,” she said. “Maternity care must be prioritized to ensure that every woman has access to the care she needs.”
The report also underscores a broader public health issue, with a recent CDC finding showing a decline in early and adequate prenatal care among women in 2023. This decline represents the second consecutive year of reduced prenatal care access, further highlighting the need for immediate action to address the growing maternity care crisis.
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