Maternity care deserts in the United States

US map of maternal mortality

Maternity care deserts in the United States, also known as maternal care deserts, are counties that lack maternity care resources. The March of Dimes defines a maternity care desert as a county that has no hospitals or birth centers offering obstetric care and no obstetric providers.[1][2] As of 2020 March of Dimes classified 1095 of 3139 of U.S. counties (34.9%) as maternity care deserts.[3] Its 2022 report indicated an increase of nearly 2%, with 1119 of 3142 US counties (35.6%) considered maternity care deserts, affecting a population of over 5.6 million women.[1][4] People living in maternity care deserts may have to travel longer distances to receive care, which is associated with higher costs and a greater risk of pregnancy complications.[5]

The March of Dimes also classifies counties as having low access to maternal care if the county has one hospital or less offering obstetric care, fewer than 60 obstetric providers per 10,000 births and 10% (or greater) of women have no health insurance.[1] Counties were classified as moderate access if they met the requirements of having low access to maternity care but the % of women with no insurance was less than 10%. A county with full access to maternity care had two or more hospitals with obstetric care facilities and 60 or more obstetric providers per 10,000 births.[1]

Maternity care deserts are associated with high maternal mortality rates.[1][6] Since 2018, there has been a 4% increase in maternity care deserts in the U.S.[1] In the United States, up to 60,000 women a year experience severe maternal morbidity, life-threatening complications as a result of pregnancy, resulting in up to 700 pregnancy-related deaths annually.[7][8] Maternal morbidity displays decades-long racial, geographical, and socioeconomic disparities. The United States is one of two countries worldwide that has reported significantly increased maternal mortality since 2000.[7]

  1. ^ a b c d e f Cite error: The named reference Brigance-2022 was invoked but never defined (see the help page).
  2. ^ Tanne, Janice Hopkins (2023-08-14). "Nearly six million women in the US live in maternity care deserts". BMJ. 382: 1878. doi:10.1136/bmj.p1878. ISSN 1756-1833. PMID 37580083. S2CID 260887893.
  3. ^ Nowhere to Go: Maternity Care Deserts across the U. S. 2020 Report (PDF). March of Dimes. 2020.
  4. ^ Carbajal, Erica (1 August 2023). "For nearly 6 million women, US is a 'dangerous' place to deliver: Report". Beckers Hospital Review. Retrieved 11 February 2024.
  5. ^ Taporco, Jason S; Wolfe, Elizabeth; Chavez, Gabriela (1 March 2021). "Kansas Maternity Deserts: A Cross-Sectional Study of Rural Obstetric Providers". Rural and Remote Health. 21 (1): 6137. doi:10.22605/RRH6137. PMID 33641336.
  6. ^ Barrera, CM; Kramer, MR; Merkt, PT; Petersen, EE; Brantley, MD; Eckhaus, L; Beauregard, JL; Goodman, DA (May 2022). "County-Level Associations Between Pregnancy-Related Mortality Ratios and Contextual Sociospatial Indicators". Obstetrics and Gynecology. 139 (5): 855–865. doi:10.1097/AOG.0000000000004749. PMC 9015027. PMID 35576344.
  7. ^ a b Wang, Siwen; Rexrode, Kathryn M.; Florio, Andrea A.; Rich-Edwards, Janet W.; Chavarro, Jorge E. (2023-01-27). "Maternal Mortality in the United States: Trends and Opportunities for Prevention". Annual Review of Medicine. 74 (1): 199–216. doi:10.1146/annurev-med-042921-123851. ISSN 0066-4219. PMID 36706746. S2CID 256325844.
  8. ^ Declercq, Eugene; Zephyrin, Laurie C. (28 October 2021). "Severe Maternal Morbidity in the United States: A Primer". The Commonwealth Fund. doi:10.26099/r43h-vh76. Retrieved 22 December 2023.