Every woman, regardless of where she lives or how much she earns, needs access to quality health care during pregnancy and birth. But a new report from the March of Dimes spotlights an alarming lack of maternal care services in many areas across the United States.
The report, poignantly titled “Nowhere to Go,” reveals that:
- 5.6 million women in the United States live in counties that have few or no maternity care services – no hospital or birth center offering obstetric care, and no obstetric providers.
- 70 U.S. counties have been added to the list of “maternal care deserts” since the organization’s 2018 report.
- More than one-third of U.S. counties lack any health services for expectant moms.
Rural Areas Fare the Worst
Difficulties surrounding Medicaid reimbursement contribute to the dearth of practicing providers. Meanwhile, doula and midwifery services are still relatively rare, especially in rural areas. Data compiled by the Government Accountability Office confirms that maternity care receives insufficient attention and resources.
In addition to the counties lacking any care, as many as 32 million women are impacted by barriers to maternal health services. Disparities are largely geographic, with rural women most likely to face difficulties. Care deserts are concentrated in states with large rural populations, like Alaska, Oklahoma, Nebraska and the Dakotas.
Lack of care links directly to another health crisis in the United States. Maternal deaths have risen in the past few years, with racial disparities in maternal deaths remaining a major concern. Black women are three times more likely to die in childbirth.
Given that more than 80% of pregnancy-related deaths in the United States are preventable, improving access to ongoing care could be an important factor in improving the outlook for pregnant women.
Policymakers Have Plans for Progress
Several organizations and national policymakers are actively seeking solutions to the ongoing maternal health crisis.
- Expanding Medicaid by raising income thresholds to make more patients eligible
- Increasing Medicaid reimbursement rates for obstetric services, especially in rural hospitals
- Extending the postpartum coverage period provided by public insurance to one year
- Integrating the skills of midwives and doulas to offer in-person care
- Improving access and coverage for telehealth services for maternal care
- Enhancing data collection to understand trends in maternal morbidity and mortality
Each new life is precious, and each woman bringing life into the world deserves access to high-quality health care services. The life-saving potential is worthy of increased attention and public investment.