Women Living in More Than a Third of U.S. Counties Have Limited Access to Maternity Care: March of Dimes Reports

More than 7 million American women, and 500,000 babies, live in areas where there is very limited access to medical care during pregnancy and birth, which are commonly referred to as “maternity care deserts”, according to the findings of a new report.

The March of Dimes indicates more than one-third of all counties throughout the U.S. qualify maternity care deserts, meaning they have no or limited access to care for pregnant women and newborns. The findings were outlined in a new report published this month, titled Nowhere to Go: Maternity Care Deserts Across the U.S..

Some counties have low or limited access to maternity care. Other counties are considered maternity care deserts because there are no hospitals with obstetric departments, there are no OB-GYNs, certified nurse midwives, and they do not have birthing centers.

March of Dimes researchers discovered a 2% increase in the number of counties classified as maternal care deserts from 2020 to 2022. Overall, 5% of counties nationwide experienced reduced maternity care access over the last two years, during the COVID-19 pandemic.

While nearly 7 million women face low or reduced access to maternity care, more than 2.2 million women live in maternal care deserts with no access to maternity care or birthing facilities, the report concluded.

Maternity Care Deserts are Growing

March of Dimes researchers indicate there has been a 2% increase in the number of counties that are considered maternal care deserts from 2020 to 2022. Overall, 5% of counties nationwide experienced reduced maternity care access over the last two years, during the COVID-19 pandemic.

More than 63% of the maternal desert counties are in rural areas. Fewer than 7% of OB-GYNs have offices in rural areas. Most are in metropolitan and urban areas.

Reduced numbers of obstetric providers in an area and hospital closures were the primary reasons for decreases in access to maternity care. Other areas of the country had a slight increase in the number of maternity care providers, but areas deemed maternal care deserts continued to grow.

A large number of maternity care deserts are in the South or Midwest, according to the report. Texas has the most maternity care deserts, and the problems in that state have worsened since 2020, according to the report.

Maternal Care in U.S. Lagging

Among highly industrialized countries, the U.S. is one of the most dangerous in the world in terms of maternal care and childbirth. The danger is markedly worse in rural areas and among communities of color.

On average, two women die every day from complications during pregnancy and childbirth and two babies die every hour.

The problem disproportionately affects women and children of color. One in eight infants are born in maternal care deserts, but one out of every four Native American babies and one in six Black babies live in maternal care deserts.

March of Dimes did not include information on abortion access, but maternity care deserts typically also have limited access to abortion care. Many of the maternity care deserts are in states which have recently passed restrictions on abortion care.

“Our 2022 report confirms lack of access to care is one of the biggest barriers to safe, healthy pregnancies and is especially impacting rural areas and communities of color where families face economic strains in finding care,” said Dr. Zsakeba Henderson, Senior Vice President and Interim Chief Medical and Health Officer.