More than a third of U.S. counties lack any medical birthing facilities or midwifery services, leading health advocates to warn of the dangers of “maternity care deserts,” a new report says.
The reportA report released Tuesday by March of Dimes, a nonprofit that advocates for infant health, found that 35.1% of U.S. counties are “maternity care deserts,” meaning there are no specialized medical services available to provide care, according to the organization.
More than 2.3 million women of childbearing age live in these 1,104 provinces, the report said. In 2022, women in these provinces gave birth to more than 150,000 babies.
The report says that women living in such health deserts and counties with low access to care are more likely to have poorer prenatal health, receive less prenatal care, and experience higher rates of preterm birth. In addition, the researchers say that women in these areas have a 13% higher risk of preterm birth.
The states with the highest percentage of so-called maternity care deserts are North Dakota, South Dakota, Oklahoma, Missouri, Nebraska and Arkansas, it added.
The researchers found that about six in 10 maternity care deserts are in rural areas and that nearly 70% of birth centers are located in just 10 states.
The report found that there has been an increase in the number of maternity unit closures in US hospitals in recent years and that more than half of US counties do not have a hospital that provides maternity care.
Since 2022, more than 100 provinces have seen a decline in the number of maternity care facilities and one in 25 obstetric units has closed, the report said, leading to fewer choices for families, “increased stress and longer travel times for people giving birth,” the report said.
In a press release After the report was released, March of Dimes Medical Director Dr. Amanda Williams called for systemic change, saying that for too many American families, “the ability to have a healthy pregnancy depends on where they live” and that “maternity care is still not a priority in our country.”
The report found that the 2022 overturning of the U.S. Supreme Court ruling in Roe v. Wade, as well as low health insurance reimbursements and payment structures, contributed to hospital closures and the decline in the number of gynecologists.
The report notes that the reversal of Roe continues to impact how and where gynecologists educate and care for their patients.
In states with strict abortion restrictions, some doctors have left because of the threat of serious consequences and penalties for performing abortions. These states have also experienced a notable decline in applications for obstetric residencies, partly due to a failure to provide training in abortion care, the report added.
The report did note that the US experienced an increase in the use of birth centers from 2017 to 2022. Birth centers, according to the American Association of Birth Centersare healthcare institutions where care is provided according to the obstetric and wellness model, but which are not hospitals.
Kali Bautista, a resident of Brownfield, Texas, told the researchers that one of her greatest fears during her pregnancy was giving birth on the way to the nearest birthing hospital, 45 minutes away. Instead, she said, she chose to receive care at a birthing center.
But the report found that there are still only 417 accredited birthing centres spread across 270 provinces, and less than 5% of them are in rural areas.
In August, the U.S. Centers for Disease Control released a report showing that fewer women received early and adequate prenatal care in 2023 than the year before, the second decline in two years.