5.6 million birthing people face limited access to maternity care due to the growing prevalence of maternity deserts and the closure of obstetric wards. Social determinants of health exacerbate maternal health outcomes. Urgent policy changes are needed to improve access to quality care and address the challenges faced by mothers and babies, as revealed by the March of Dimes report.
A concerning rise in maternity deserts and inadequate access to care has left a staggering 5.6 million birthing individuals without proper maternity services, as reported by March of Dimes. The closure of obstetric wards is identified as a significant factor contributing to this problem.
This issue is compounded by various social determinants of health that disproportionately affect maternal health outcomes, as highlighted by the report authors.
The healthcare industry is grappling with a severe maternal health problem, with the United States showing the worst maternal health outcomes and equity among developed nations. Additionally, the Supreme Court’s reversal of Roe v. Wade has raised concerns about access to all types of reproductive healthcare, not just abortion.
March of Dimes is now shedding light on the state of birthing and maternity care access, specifically focusing on maternity care deserts. The organization emphasizes that a person’s ability to have a healthy pregnancy and birth should not be dictated by their location and access to quality care.
Approximately 5.6 million birthing people reside in counties with either no access or limited access to maternity care services, primarily due to the closure of obstetric units in hospitals. Since the 2018 report, 369 counties have witnessed the shutdown of their obstetric units, affecting one in ten counties. Moreover, 70 more counties have been labeled as maternity care deserts following additional obstetric ward closures.
The closures are often driven by low birth volumes and rising costs, as a significant portion of births in maternity care deserts is reimbursed through Medicaid, which offers lower reimbursement rates than private insurance. Consequently, hospitals facing financial constraints often choose to close obstetric wards.
This unfortunate trend has dire consequences for maternal health. The report reveals that over 32 million women of reproductive age face a higher risk of poor health outcomes due to limited access to reproductive healthcare. This is particularly common in rural states like North Dakota, South Dakota, Alaska, Oklahoma, and Nebraska.
Furthermore, social determinants of health play a crucial role in these issues. Factors such as the environment, socioeconomics, housing access, and pollution can significantly limit access to prenatal care, particularly affecting women of color. Additionally, chronic diseases are prevalent among maternity care deserts, with eight out of ten having a large population of pregnant individuals with chronic illnesses that impact birthing conditions, such as preeclampsia and pre-term birth.
To address these challenges and improve maternal health outcomes, the March of Dimes calls for high-level policy changes. This includes legislation that supports and sustains telehealth access, state perinatal regionalization programs to expand care access, and initiatives to bolster the healthcare workforce.
The organization advocates for the expansion of Rural Maternity and Obstetrics Management Strategies (RMOMS) and Rural Obstetrics Access and Maternal Services (ROAMS) in all states. Additionally, it supports extending Medicaid postpartum coverage from 60 days to a full year nationwide.
Overall, the current state of maternity care access demands urgent action to ensure that every baby receives a healthy start to life and that every family has equitable, available, and quality maternal care. By addressing the unique challenges faced by mothers and babies at the local level, solutions can be put in place to build a better future for all families.
