Week 8 - Material review: "Maternity care deserts"

What is a maternity care desert (or maternal care desert)?

A county that lacks maternity care resources — meaning no hospitals or birth centers offering obstetric care and no obstetric providers (obstetricians, midwives).

Approximately how many U.S. counties are classified as maternity care deserts in the 2022 March of Dimes report?

About 1,119 counties — representing around 35–36% of all U.S. counties.

Roughly how many women of childbearing age are affected by low-access or no-access counties, according to that report?

Up to 6.9 million women live in areas with low or no access to maternity care across the U.S.

How many births occur in maternity care deserts in those affected counties?

Nearly 150,000 births occur in maternity care desert counties

What percentage increase in counties with reduced access was found since the 2020 report?

A 5% increase in counties with reduced maternity care access, including a 2% increase in counties classified as deserts.

Which states were mentioned as having some of the most affected populations or biggest declines in access?

• Ohio had a large number of women affected by declines in access (~97,000)

• Florida was noted for many women impacted by shifts in access (~92,000) in improvements

What are some of the risk factors or associated challenges for people living in maternity care deserts?

• Poorer health before pregnancy

• Less prenatal care

• Higher rates of preterm birth (excess of ~10,000 preterm births linked to these areas)

• Travel distance and barriers to access

• Lack of telehealth or broadband access

What are some policy recommendations or interventions proposed to address maternity care deserts?

• Expand Medicaid postpartum coverage (e.g. from 60 days to 12 months)

• Expand telehealth services for maternity care (though must address broadband limitations) 

• Increase support for midwives and doulas, integrate them more broadly

• Strengthen network adequacy requirements for health plans under the ACA

• Use Federally Qualified Health Centers (FQHCs) or mobile health units to fill gaps