Maternity Care in the United States

A recent report highlights a persistent maternity health crisis in the United States, revealing that 1 in 3 counties lack any obstetric clinicians, which significantly impacts women's access to care. The report, published Tuesday by the maternal and infant health nonprofit March of Dimes, indicates that in many areas across the country, obstetricians, gynecologists, and family physicians who assist in deliveries are retiring or leaving the field, exacerbating access to care issues. While ob/gyns were responsible for delivering over 85% of babies born in 2022, according to the report, the American College of Obstetricians and Gynecologists (ACOG) now forecasts a shortage of 12,000 to 15,000 ob/gyns by 2050.

According to March of Dimes, over 35% of U.S. counties are classified as "maternity care deserts," indicating that they have limited or no access to maternity care services. In approximately 1,104 counties, there are no birthing facilities or obstetric clinicians available, affecting over 2.3 million women of reproductive age. These women gave birth to over 150,000 babies in 2022. According to the new report, residing in a maternity care desert increases the risk of preterm birth by 13%. Additionally, about 60% of these maternity care deserts are located in rural areas.

To enhance access to maternity care in the U.S., March of Dimes advocates for expanded training programs to increase the number of midwives in the healthcare workforce and for greater investment in telehealth to reach more patients, among other measures. “We need to boost our capacity to care for patients, especially since low-risk pregnancies are ideally managed by experts in physiologic birth, such as midwives,” Williams said. “Currently, only about 10% of births in the U.S. involve midwives, a stark contrast to most European countries where midwives attend the majority of births and maternal mortality rates are significantly lower,” she noted. “In the U.S., nurse midwives contribute to lower C-section rates and reduced preterm birth rates.”

Dr. Georges Benjamin, executive director of the American Public Health Association, described the findings in the new report as "quite frightening," highlighting them as a consequence of the underfunding of the country’s public health infrastructure. “This underscores the critical shortcomings in health system planning,” Benjamin said. “The areas experiencing gaps in maternity care align with regions that also suffer from inadequate access to health insurance and face the highest rates of morbidity and mortality from chronic diseases, particularly in the South and parts of the Midwest,” he added. “We have a significant deficiency in health system planning and policies to ensure comprehensive access to care.”

As an employer, addressing these health care deserts and implementing effective care navigation solutions to ensure your employees receive excellent maternity care is crucial. Acrisure offers several resources to assist in this area, so please feel free to reach out with any questions.