Hundreds of hospitals have lost their childbirth units over the past five years, according to a new analysis, affecting about a tenth of US counties and contributing to increasing limitations to access maternity care nationwide.
March of Dimes, a nonprofit focused on infant and maternal health, on Tuesday published a series of reports exploring access to family planning and maternity care.
Nationwide, they found more than a third of US counties to be maternity care deserts, without a hospital or birth center offering obstetric care and without any obstetric providers. About 300 birthing units have closed in the US since March of Dimes first started tracking in 2018, including about 70 losses in the past year.
Eight counties in Texas were among those newly designated as maternity care deserts. And earlier research suggests that a strict abortion law that took effect in the state in 2021 may have led to increased demand for care, with nearly 10,000 more births than expected in the last nine months of 2022.
Overall, nearly 1 in 10 women who gave birth in the past year lived more than 30 minutes away from the closest birthing hospital, according to the new March of Dimes analysis.
The burden is particularly high for those living in rural areas. The average distance to a birthing hospital was highest in North Dakota, at more than 32 miles away. And the gap is stark in Alabama, where women living in rural areas have to travel more than twice as far as the state average to get to the nearest hospital with maternity care. About 90% of women living in rural areas of the Alabama have no maternity care hospitals within 30 minutes.
“A person’s ability to have a healthy pregnancy and healthy birth should not be dictated by where they live and their ability to access consistent, quality care but these reports shows that, today, these factors make it dangerous to be pregnant and give birth for millions of women in the United States,” said Dr. Elizabeth Cherot, president and chief executive officer for March of Dimes.
Other research has found that maternity care deserts are linked to a lack of adequate prenatal care or treatment for pregnancy complications and even an increased risk of maternal death for a year after giving birth.
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People with chronic health conditions, such as hypertension and diabetes, have an increased risk of poor pregnancy outcomes including preterm birth. Overall, lack of access to reproductive health care services such as family planning clinics leaves more than 32 million women of reproductive age vulnerable to poor outcomes, according to the new analysis from March of Dimes.
And those risk factors are more common among those living in maternity care deserts. For example, about 47% of Black women have at least one chronic health condition – but about 56% of Black women living in maternity care deserts do. And the preterm birth rate for Black women is 15% higher for those living in maternity care deserts.
“Every baby deserves the healthiest start to life, and every family should expect equitable, available, quality maternal care,” Cherot said. “These new reports show that the system is failing families today but paints a clear picture of the unique challenges facing mothers and babies at the local level—the first step in our work to put solutions in place, and build a better future for all families.”
