In its latest report, Nowhere to Go: Maternity Care Deserts Across the U.S., March of Dimes shines a sobering light on a growing healthcare crisis: the lack of maternity care in vast regions of the country. These maternity care deserts—defined as counties without hospitals, birth centers offering obstetric care, or obstetric providers—are impacting millions of women and families, creating disparities in maternal and infant health outcomes.
What Are Maternity Care Deserts?
A maternity care desert is a county that lacks access to basic maternity services, such as obstetric care or prenatal and postpartum support. March of Dimes reports that over 35% of U.S. counties fall into this category, affecting more than 2.3 million women of reproductive age. Each year, over 150,000 births occur in these underserved areas.
Key Findings from the 2024 Report
Worsening Access: More than 100 counties have lost access to maternity care since the last report in 2022. Over 100 hospitals across the country have shut down obstetric units, forcing pregnant women to travel longer distances for care—often with significant delays in receiving emergency services.
Geographical Disparities: States with the highest percentages of maternity care deserts include North Dakota, South Dakota, Alaska, Oklahoma, and Nebraska.
Health Risks: Those living in maternity care deserts face a 13% higher risk of preterm birth. These regions also report higher rates of inadequate prenatal care, particularly among people of color and those with lower incomes.
What’s Driving the Crisis?
The rise in maternity care deserts can be attributed to several systemic factors:
Hospital Closures: Financial pressures on hospitals, particularly in rural and low-income areas, have led to the closure of obstetric units. Many for-profit hospitals have discontinued maternity services to cut costs, further isolating families in need of care.
Socioeconomic Disparities: Black individuals, already at a disproportionately higher risk of pregnancy-related mortality, are further impacted by a lack of accessible maternity care. Systemic inequities and socioeconomic challenges compound this disparity, leading to worse outcomes.
Health Professional Shortages: A nationwide shortage of obstetricians, midwives, and nurses exacerbates the problem, leaving many communities without skilled providers to deliver care.
The Impact on Families
The closure of obstetric services and the rise in maternity care deserts mean more families are faced with critical delays in accessing care. Expectant people in these areas may not receive timely prenatal care, increasing risks for both maternal and infant health complications. These issues are particularly pronounced for communities of color, who already experience disparities in healthcare access and outcomes.
How Do We Solve This Crisis?
Addressing maternity care deserts requires immediate action and collaboration between policymakers, healthcare providers, and community leaders. March of Dimes offers several solutions to mitigate the crisis:
Increase Medicaid Reimbursement Rates: By raising reimbursement rates for maternity services, hospitals in underserved areas can sustain their obstetric units and attract skilled providers.
Expand Telehealth Services: Telehealth can bridge gaps in prenatal and postpartum care for those who live far from healthcare facilities.
Invest in Community-Based Care: Supporting midwifery and community birth centers, particularly in rural areas, can improve access to quality maternity care.
A Call to Action
The 2024 March of Dimes report is a wake-up call. For too many people in the United States, access to maternity care is not a given—it’s a privilege. Policymakers, healthcare systems, and communities must work together to close these gaps and ensure that every person, regardless of their zip code, can access the care they needs for a healthy pregnancy and birth.
This issue isn’t just about healthcare—it’s about equity, dignity, and the right to safe and compassionate maternity care. It’s time to act.
For more information and to read the full report, visit March of Dimes or https://www.marchofdimes.org/maternity-care-deserts-report
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