Millions of families across the country are unable to access maternity care, according to a new report from the March of Dimes.
The 2024 Nowhere to Go: Maternity Care Deserts in the US Report found that more than 35 percent of U.S. counties are maternity care deserts, meaning they are an area without a single birthing facility or obstetrician clinician. These 1,104 counties are home to more than 2.3 million women of reproductive age and more than 150,000 babies were birthed by women living in a maternity care desert.
The report underscores the urgent need for action to address the ongoing maternal health care crisis in the U.S. to ensure all mothers and babies have access to quality care.
"For too many families across the U.S., the ability to have a healthy pregnancy depends on where they live," said Amanda Williams, M.D., chief medical officer, March of Dimes, in a statement. "Our 2024 report underscores that maternity care is still not prioritized in our country and there is an urgent need for systemic changes to improve outcomes for moms and babies in the U.S. and to ensure that these families have access to the care they need and deserve."
Additional report findings include:
- The states with the highest percentage of maternity care deserts include North Dakota (73.6 percent), South Dakota (57.6 percent), Oklahoma (51.9 percent), Missouri (51.6 percent), Nebraska (51.3 percent), and Arkansas (50.7 percent).
- Living in a maternity care desert or low access county is associated with a 13 percent and 11 percent increased risk for preterm birth, respectively.
- Approximately 70 percent of all birth centers are located within 10 states.
- In 2021 and 2022, approximately one in 25 obstetric units closed nationwide.
- People living in maternity care deserts travel 2.6 times longer (38 minutes) to reach a birthing hospital compared to those living in full access counties (14.4 minutes).
- Chronic conditions, such as pre-pregnancy obesity, hypertension, and diabetes, have increased significantly since 2015 and are most common among women living in maternity care deserts. These conditions are also most prevalent among Black and American Indian/Alaska Native women.
March of Dimes recommended several policy solutions and actions to improve the health outcomes of mothers and babies across the U.S. Their recommendations include:
- Address reimbursement and administrative barriers
- Consider alternative payment methods for maternity care
- Expand Medicaid in all states
- Review state regulatory barriers to maintain and establish birth centers
- Expand opportunities for full midwifery integration
- Invest in digital technologies and telehealth