Significant Gaps in U.S. Obstetric Care Access Revealed
A recent report by March of Dimes indicates that over a third of counties in the United States face significant obstacles in accessing obstetric care. The report, released on Tuesday, reveals that 34.6% of U.S. counties are classified as “maternity care deserts,” affecting approximately 2.4 million women of reproductive age and 149,000 newborns each year. The women living in these areas, many in rural locations, typically have to travel about three times further to obtain labor and birth services compared to those in counties with better access.
Additionally, around 3.4 million women and 209,000 infants reside in counties with “low or moderate” access to obstetric care. Alarmingly, over half of U.S. counties lack hospitals that provide delivery services, impacting around 370,000 births annually.
“Families across the nation face unnecessary obstacles in accessing obstetric care, as healthcare changes and policy decisions threaten to deepen existing disparities,” stated Cindy Lerman, President and CEO of March of Dimes. “We need to rethink maternity care to create healthier beginnings, stronger communities, and improved outcomes for future generations.”
The report highlights that the shortage of obstetric clinicians is particularly severe in rural areas, with nearly 58% of these counties lacking an obstetrician, in contrast to approximately 19% in urban regions. Furthermore, an estimated 96 labor and delivery department closures have been announced in 35 states between January 2024 and May 2026.
“This report underscores that obstetric deserts are not a coincidence, but rather a direct result of policy choices that leave many families without vital care,” commented Dr. Michael Warren, March of Dimes’ chief medical and health officer. “The well-being of mothers and babies relies on robust support systems that are currently faltering.”
Warren also noted that solutions are attainable but require coordinated efforts from healthcare providers, policymakers, employers, and communities. “This crisis cannot be resolved in isolation,” he added.
The March of Dimes estimates that about 1 in 9 women of reproductive age nationwide are uninsured, with the highest rates found in the South, rural areas, and those designated as maternity care deserts.
This report arrives at a time when many rural hospitals in the U.S. have stopped providing delivery services. Since late 2019, 139 rural hospitals have ceased deliveries, leading to a 13% reduction in the rural workforce and delivery units. Estimates suggest these changes may further exacerbate the accessibility crisis.
Women in rural areas frequently encounter challenges like limited access to obstetric care, reproductive health services, postpartum support, and paid leave. A September 2022 report asserted that inadequate maternal and child health care in these areas can result in significant issues like premature birth, low birth weight, and increased maternal and child morbidity and mortality.
Moreover, rising costs associated with maternity care have posed significant economic burdens for many American women. A recent KFF analysis indicated that women enrolled in employer plans faced average medical costs of $20,416 related to pregnancy, childbirth, and postpartum care.
