Seven Million American Women Of Childbearing Age Live In Counties With Limited Or No Maternity Care

September 23, 2020

March of Dimes, the nonprofit organization leading the fight for the health of all moms and babies, today released a new report entitled Nowhere to Go: Maternity Care Deserts Across the U.S. The report, published with the support of partners at RB’s Enfa portfolio of brands through our joint Better Starts for All initiative, finds that seven million American women of childbearing age, 35 percent of which are women of color, live in counties without access or with severely limited access to vital maternity care where 500,000 babies are born each year.  More than 2 million women live in maternity care deserts, counties with no access to maternity care, facing additional barriers to care. Without access to routine, quality health care these moms and babies have an increased risk of serious health complications, including maternal and infant mortality and morbidity, as well as low birth weight and preterm.

“Maternity care deserts expose the serious and sometimes deadly issues that can result from lack of access to care for moms and babies,” said Stacey D. Stewart, President and CEO of March of Dimes. “This situation is unacceptable, especially when considering that COVID-19 has put additional strain on our healthcare system and potentially forced the closure of additional maternity wards. We must work to address the systemic health disparities that exist in our nation and find real solutions for these seven million women living without full access and mobilize virtual services, including telehealth and peer-to-peer support services, to provide aide to women living in these deserts.”

The 2020 report showcases the maternity care desert status of all counties across the U.S. based on the most recent data on availability of hospitals, birth centers, OB providers and health insurance. It also includes new sections on COVID-19 and pregnancy, telemedicine and information on the role of doulas in maternity care. Due to the impact of COVID-19, health systems and/or hospital-based maternity care centers located in both urban and rural areas are facing unpresented financial declines that could necessitate the increased closure of maternity care centers, further contributing to the troubling gap.

Additional key findings of the report include:

  • 54% of counties across the U.S. have limited or no access to maternity care and 35% of these counties are considered deserts.
  • More than 2 million women of reproductive age live in one of 1,095 maternity care desert counties, with no hospital offering obstetric (OB) care, no birth center, and no OB provider.
  • An additional 4.8 million women of reproductive age live in counties with limited access to maternity care.
  • An urban environment does not equate to better care. 3.3 million women (47.5%) live in urban counties, yet still lack full access to maternity care. 740,000 of these women live in maternity care deserts with no access to maternity care.
  • Women of color represent 35% of the women of childbearing age in areas of no or very limited access to maternity care.
  • Since the last Maternity Care Deserts report in 2018, March of Dimes found six percent of counties had shifted, with equal percentages achieving higher and lower levels of care and three counties moving out of the maternity care desert classification.

Policymakers and advocates must come to together to tackle the impossible gaps so many of our mothers are facing through a coordinated series of policies demanding equity, access and prevention – an agenda March of Dimes calls #BlanketChange.

Through the #BlanketChange agenda, March of Dimes and its partners are calling on candidates and elected official to protect and improve maternal and infant health by:

  • Eliminating racial and ethnic health disparities and driving economic, social and health equity by focusing on prevention, treatment and social determinants of health.
  • Improving access to care through expanding critical health programs and closing gaps in coverage.
  • Addressing preventable health conditions through expanding research and improving maternal morbidity and mortality data collection.

“This is not a rural issue or urban issue – this is an American issue. Just as you can’t separate the health of moms and babies, you can’t take moms and babies out of their economic and social environment – the community where they live and the larger systems that guide our health care, housing, education, and employment systems. This is why it is critical to adopt a holistic and comprehensive agenda to support moms and babies,” said Dr. Rahul Gupta, Chief Medical and Health Officer, Senior Vice President and Interim Chief Scientific Officer at March of Dimes. “In this election year, March of Dimes is calling on candidates and policymakers at all levels - federal, state and local – to take the steps to address the maternal and infant health crisis.”

In the U.S., significant racial and ethnic disparities exist in maternal care with communities of color disproportionately impacted by the maternal and infant health crisis. Ensuring access to maternity care for all women has the potential to reduce disparities and improve birth outcomes for all.

“The United States is in the grips of a national maternal and infant health crisis, and it’s well-beyond the point that our country should treat it like one,” said Olympian and March of Dimes advocate Allyson Felix. “This crisis is disproportionately impacting moms and babies of color and we urgently need blanket policy change that can improve access to care, eliminate health disparities, address preventable conditions, and drive health and social equity. It’s time for communities, candidates, and policymakers to address these issues with the attention and action they deserve.”

Visit to learn more and join the following organizations that have already signed on to support the #BlanketChange campaign to date.

#BlanketChange Partner Organizations Include:

A Better Balance
AMAG Pharmaceuticals
American Academy of Pediatrics
American College of Clinical Pharmacy
American Organization for Nursing Leadership
American Public Health Association (APHA)
Association of Maternal & Child Health Programs
Charity Miles
Child Welfare League of America
Children’s Defense Fund
Community Health Charities
District Motherhued
DONA International
EMD Serono
Ferring Pharmaceuticals
First Focus Campaign for Children
Florida Chapter of American Academy of Pediatrics, Inc.
General Federation of Women's Clubs
Kiwanis International
Mama Glow
March for Moms 
Maternal Safety Foundation
National Association of Chain Drug Stores
National Association of Nurse Practitioners in Women’s Health
National Association of Pediatric Nurse Practitioners
National Basketball Wives Association  
National Birth Equity Collaborative
National Family Planning & Reproductive Health Association
National WIC Association
Nurse-Family Partnership
Our Little Preemie
Ovia Health
Preeclampsia Foundation
RB’s Enfa portfolio of brands
Sisters in Loss
Society for Reproductive Investigation 
Star Legacy Foundation
Tara Hansen Foundation
The American College of Obstetricians and Gynecologists
The Coalition of Labor Union Women
Top Ladies of Distinction, Inc.
Zeta Phi Beta Sorority, Incorporated