Nowhere to Go: Maternity Care Deserts Across the US

The 2024 March of Dimes report, Nowhere to Go: Maternity Care Deserts Across the U.S., highlights the lack of maternity care access in many parts of the United States, especially in rural areas. Key findings from the report include:

Maternity Care Deserts: Over 35% of U.S. counties are considered maternity care deserts. Maternity care deserts are counties without access to birthing hospitals, birth centers offering obstetric care, or obstetric providers. These counties are home to over 2.3 million women of reproductive age, and 150,000 babies were born in these areas in 2022.

Obstetric Unit Closures and Workforce Shortages: One in 25 obstetric units in the U.S. closed in the past two years, contributing to increased travel times and stress for birthing people. There is also a significant shortage of obstetric clinicians, with nearly half of all U.S. counties lacking an OB-GYN.

Health Disparities and Outcomes: Women living in maternity care deserts experience poorer health outcomes, including higher rates of preterm birth. The report associates living in a maternity care desert with a 13% increased risk of preterm birth.

Policy Recommendations: The report emphasizes the need for policy changes to improve access to maternity care, including reducing barriers to midwifery care, supporting the establishment of birth centers, and addressing low insurance reimbursement rates contributing to hospital closures.

Insurance and Access Issues: The lack of continuous insurance coverage for women of reproductive age poses a significant barrier to accessing timely and appropriate care. The report advocates for Medicaid expansion and extension policies to improve access.

Social Drivers of Health: The report discusses how social determinants of health impact access to maternity care and outcomes. It calls for systemic changes to address these inequities.

The report shows the urgent need for coordination and collaboration among policymakers, healthcare providers, and communities to ensure equitable access to quality maternity care for all women, regardless of their geographic location.