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March of Dimes report: 2.3M women live in maternal care deserts
According to a 2024 report by March of Dimes, 35% of U.S. counties are maternity care deserts, with roughly 2.3 million women of reproductive age living in these areas.
March of Dimes recently published "Nowhere to Go: Maternity Care Deserts Across the US," a report analyzing access to maternal healthcare in the United States. As with previous years' reports, the 2024 document highlights an alarming number of maternal care deserts and emphasizes a need for collaboration between policymakers, healthcare providers, and community leaders to address the ongoing problem.
Maternal healthcare across the United States has been a hot topic of conversation over the past few years. When Roe v. Wade was overturned during Trump's presidency, access to comprehensive reproductive healthcare -- which includes maternal healthcare -- became an even greater concern, as many individuals living in states with abortion bans also live in maternal care deserts.
According to March of Dimes, approximately 4% of obstetric units in the U.S. have shut down in the past two years, further exacerbating the maternity care desert crisis.
The report looked at multiple factors that could impact access to maternal care, including chronic conditions, the availability of hospitals and birth centers, travel time to care, the availability of obstetric clinicians, fertility rates, and health insurance coverage.
What is a maternity care desert?
March of Dimes divided communities into four groups: maternity care desert, low access, moderate access and full access. They designated a community as a maternity care desert if there were zero hospitals and birth centers offering obstetric care, zero obstetric clinicians per 10,000 births and any number of women 19-54 without health insurance. On the opposite end of the spectrum, full access included communities with two or more hospitals and birth centers offering obstetric care, 60 or more obstetric clinicians per 10,000 births, and any number of women 19-54 without health insurance.
Low and moderate access included communities with fewer than two hospitals and birth centers offering obstetric care and fewer than 60 obstetric clinicians per 10,000 births. However, in low access areas, 10% or more of women 19-54 did not have health insurance, while in moderate access areas, less than 10% of women 19-54 did not have health insurance.
With this criteria, March of Dimes determined that 35.1% of U.S. counties, or 1,104 counties, were classified as maternity care deserts. Additionally, 3.6% of women of reproductive age, or 2.3 million women, live in maternity care deserts. The report also estimated that 4.1% of babies, or 150,000 babies, were born to individuals who lived in maternity care deserts.
Recommended solutions as diverse as the obstacles
Limited access to maternal healthcare has been linked to poor maternal and infant health outcomes. A 2024 study in BMC Health Services Research noted that living in rural communities with limited access to maternal healthcare has been linked to a greater risk of maternal morbidity and mortality, higher rates of preterm birth, higher rates of infant mortality and lower birth weights.
Despite the bleak findings in this report, March of Dimes offers some policy recommendations to address these issues. These include policies for addressing reimbursement and administrative barriers, exploring alternative payment methods for maternal care, adopting Medicaid extension and expansion, reviewing regulatory barriers, expanding midwifery integration, and investing in digital technologies and telehealth.
"The solutions to improving access to maternity care are as diverse as the barriers. However, by addressing these multifaceted challenges and implementing targeted interventions and policy solutions, we can work towards a future where all moms and babies receive the care they need, regardless of their geographic location, socioeconomic status, sexual orientation, or racial background. Stakeholders at all levels must collaborate to enact policy reforms, invest in workforce development, and prioritize equity to improve maternal health outcomes nationwide," the report concluded.
Veronica Salib has covered news related to the pharmaceutical and life sciences industry since 2022.
