Maternity Care ‘Deserts’ Common Throughout America, Report Shows

WEDNESDAY, Aug. 2, 2023 (HealthDay News) -- More U.S. women are living in areas with little or no maternity care, raising concern about their ability to have a healthy pregnancy and birth.

New research from the March of Dimes shows a 4 percent drop in birthing hospitals throughout the United States and Puerto Rico and decreased access to maternity care in 369 counties since 2018. More than 32 million women lack access to reproductive health care services, including family planning clinics and skilled birth attendants. More than 5.6 million live in counties with little or no access to maternity care services. These maternity care "deserts" leave them vulnerable to poor health outcomes.

Since the March of Dimes 2018 report (before the COVID-19 pandemic), 70 more counties were classified as maternity care deserts due to a loss of providers and obstetric units in hospitals. The new report looked at each state, as well as Washington, D.C., and Puerto Rico. States with the highest rates of maternity care deserts were the Dakotas, Alaska, Oklahoma, and Nebraska.

Hospitals were closing maternity units even before the pandemic because of rising costs and low birth volume, the report noted. Among other contributors, obstetrics is a medical field with a high burnout rate, according to the American College of Obstetricians and Gynecologists. In addition, more than 50 percent of births in maternity care deserts are covered by Medicaid, which provides lower reimbursement rates, according to the American Hospital Association.

Environmental and economic factors as well as chronic health conditions also factor in. The report shows that violent crime rates, pollution, and housing conditions consistently indicate a higher percentage of inadequate prenatal care. This is especially true for women of color. Other societal factors that appear to have an impact on prenatal care in high-risk communities include educational attainment, social support, poverty, and food security. About eight of 10 maternity care deserts have a high burden of preexisting chronic health conditions in pregnant women, including high blood pressure, diabetes, weight, and smoking, which can affect birth outcomes, according to the report.

Among other initiatives, the March of Dimes supports legislation, programs, and funding to sustain and expand telehealth programs for maternity care; state efforts to expand access to care; and workforce programs that support expanding health care personnel in rural and underserved communities. The March of Dimes also supports all states extending Medicaid's postpartum coverage from 60 days to a full year. The organization is funding a number of initiatives aimed at addressing the shortages.

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