Q&A: 35% of US counties are maternity care deserts, leaving millions without access

Key takeaways:

• Recent data revealed that millions in the U.S. live in maternity care deserts.
• Another report, however, highlighted the best hospitals for maternity care in the country.

New data provide valuable insights into the level of access to maternity care in communities across the United States, according to an expert.

A recent report from March of Dimes revealed “the worsening state of maternity care across the country,” according to a press release.

Since the last report in 2022, more than 100 hospitals shuttered their obstetric units, leading to a significant decrease in maternity care access, according to the release. Now, more than one-third of counties in the U.S. are classified as maternity care deserts, and patients in these areas see a 13% higher preterm birth risk.

Complementary data from U.S. News & World Report, however, recognize the 73 Maternity Care Access Hospitals in the country. Taken together, these reports can help primary care providers get a clearer picture of maternity care in their communities.

Healio spoke with Jennifer Winston, PhD, a health data scientist at U.S. News & World Report, to learn more about the new data and what PCPs need to know.

Healio: Why are these data important?

Winston: As the most recent report from the March of Dimes highlights, over 35% of counties in the U.S. are considered maternity care deserts. Women living in those areas have to travel further to a facility providing maternity care, which makes it harder for them to receive the prenatal and maternity care that they need.

However, there are still a number of hospitals that are trying to fill the growing gap by providing critical care to communities that wouldn't otherwise have access. U.S. News recognizes those hospitals as maternity care access hospitals; hospitals across the U.S. serving communities that depend on them for access to vital maternity care services.

Healio: Will you discuss the role equity plays in this? Are there some groups that are less likely to get maternity care?

Winston: Maternity care deserts are disproportionately located in the Midwest and Southeastern U.S. These regions often coincide with higher rates of child poverty than the remainder of the country, meaning that some of the most economically vulnerable patients end up traveling the furthest to access care.

Healio: What are some solutions here? How can these care gaps be closed?

Winston: Falling reimbursement rates, low birth volumes and difficulty retaining clinicians in rural areas is putting pressure on rural maternity care hospitals. Hospitals and some health care experts say higher reimbursement for maternity services would help make it viable for hospitals to continue to provide maternity services, especially in rural areas. Clinicians also need to feel safe in providing appropriate maternity care to their patients.

Healio: What role should PCPs play in these solutions? How can they help patients access maternity care?

Winston: We have seen anecdotal evidence that PCPs’ willingness to partner with community-based midwives or other providers can help bridge the gap in prenatal care. This can help improve outcomes even if the patient still needs to travel a longer distance for labor and delivery.

Healio: What is the take-home message for PCPs here?

Winston: We recognize the challenges that many clinicians are facing in providing maternity services to rural communities. U.S. News will continue to recognize maternity care hospitals that are continuing to provide vital services to under-resourced communities through our maternity care access hospital designation.

Healio: Is there anything else you would like to add?

Winston: The March of Dimes has done such important and honorable work highlighting the maternity care deserts crisis.

References:

• Best hospitals for maternity care (uncomplicated pregnancy). Available at: https://health.usnews.com/best-hospitals/hospital-ratings/maternity. Accessed Oct. 21, 2024.
• March of Dimes 2024 maternity care deserts report reveals millions of families unable to access maternity care. Available at: https://www.marchofdimes.org/about/news/march-dimes-2024-maternity-care-deserts-report-reveals-millions-families-unable-to. Published Sept. 10, 2024. Accessed Oct. 21, 2024.
• Nowhere to go: Maternity care deserts across the U.S.
• Available at: https://www.marchofdimes.org/maternity-care-deserts-report. Accessed Oct. 21, 2024.