Where You Live Matters: Maternity Care Deserts and the Crisis of Access and Equity

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Maternity care deserts are counties where there’s limited or no access to birthing hospitals, birth centers offering obstetric care, or obstetric providers. Areas with low or no access to maternal care affect over 5.6 million women and nearly 350,000 births across the U.S.

Where You Live Matters: Maternity Care Deserts and the Crisis of Access and Equity is a set of 52 comprehensive reports examining maternity care deserts and other factors that impact access to care, health outcomes, and unique barriers for all families in each state, the District of Columbia, and Puerto Rico.

Since 2018, March of Dimes has published data on maternity care deserts across the U.S., highlighting areas with inequitable access to maternity care providers and birthing facilities. These reports represent some of the most comprehensive analyses of its kind looking at maternity care access, examining data beyond maternity care deserts, and other key issues impacting access to care and maternal health outcomes. The data consistently shows that access to maternity care continues to decline, and more resources are needed to make maternal health a priority.

Janette had to travel over an hour to the nearest hospital via a rideshare service for prenatal care appointments and to give birth—all while overcoming substance use disorder. Today, her and her family still struggle to get what they need.

Autumn found out she was pregnant with her first child the same month she was awarded custody of her four younger siblings. Now, 31 weeks pregnant and living in a maternity care desert, she fears she might go into labor in her car.

Claudia knows from experience the dangers of living in a maternity care desert, having delivered her second child in her car. Now, pregnant with her fifth child, she’s concerned this pregnancy will have a similar outcome.

Like most pregnant women in her county, Natalia gets her prenatal care in the nearest city where better resources and hospitals are available. But that’s a long drive away. At six months pregnant, the road is starting to wear on her.

Due to the birthing center in Kali’s rural hometown having a history of being unequipped and not wanting to risk the long drive to the nearest city’s hospital, Kali decided to take her maternity care into her own hands.