Maternity care lacking across United States

Maternity care lacking across United States | Image Credit: © Pituk - © Pituk - stock.adobe.com.

According to recent reports from March of Dimes, over 5.6 women live in counties with no or limited access to maternity care service.

March of Dimes has investigated maternity care use since 2018, determining locations which are “maternity care deserts.” Maternity care deserts are counties lacking obstetric care and obstetric providers through a hospital or birth center. Over 36% of counties in the United States have been identified as maternity care deserts.

According to the reports, over 369 counties in the United States saw decreased maternity care access because of the loss of obstetric units in hospitals. This made up almost 1 in 10 US counties. An additional 70 counties were identified as maternity care deserts because of the loss of obstetric units and obstetric providers in hospitals.

A high risk of poor health outcomes is seen in over 32 million women of reproductive age because of not being able to access reproductive healthcare services such as skilled birth attendants and family planning clinics. North Dakota, South Dakota, Oklahoma, Alaska, and Nebraska are states with a high prevalence of maternity care deserts, which are common in rural regions.

Hospitals have recently faced issues with staffing, recruitment, and maternity unit closures. A low birth volume and increasing costs led many hospitals in the United States to close maternity units even prior to the COVID-19 pandemic. 

Medicaid reimbursement has decreased rates, but according to the American Hospital Association, Medicaid reimburses over 50% of births in maternity care deserts. Additionally, obstetrics has one of the highest burnout rates in medical specialties, according to the American College of Obstetricians and Gynecologists.

Pregnancy and birth outcomes are impacted by hospital closures, chronic health conditions, environmental factors, and socioeconomic issues, with poorer prenatal care associated with pollution, violent crime rates, and housing conditions. Women of color are especially impacted by these factors.

A high burden of pregnant individuals with pre-existing chronic health conditions has been reported in 8 out of 10 maternity care deserts, increasing the risk of conditions such as preterm birth and preeclampsia. This often leads to an increased burden of care among women in communities without access to well-equipped facilities and trained providers.

These reports showcase a need for change in access to maternity care. This can be accomplished through programs, legislation, and funding focused on expanding telehealth programs for consumers and providers, state programs expanding care access, and health care programs expanding health care worker presence in rural communities.

Reference

New March of Dimes research shows access to maternity care worsening for millions of women in the US. March of Dimes. August 1, 2023. Accessed August 2, 2023. https://www.marchofdimes.org/about/news/new-march-dimes-research-shows-access-to-maternity-care-worsening-millions-women-us#:~:text=August%201%2C%202023%20(Arlington%2C,forcing%20families%20to%20find%20new