Over one-third of counties in the United States lack hospital birthing units or obstetric doctors, according to a report published Tuesday by the March of Dimes.
The report, titled “Nowhere to Go: Maternity Care Deserts Across the U.S.,” indicates that 34.6% of U.S. counties qualify as maternity care deserts. These areas are home to roughly 2.4 million women of childbearing age, with about 149,000 babies born in these counties each year. An additional 3.4 million women live in areas with low or moderate access to care.
According to the data, 96 labor and delivery units across 35 states closed between January 2024 and May 2026. In nearly 60% of the affected counties, the closed facility was the only local option for labor and delivery services. On average, those closures added 25 minutes of travel time for patients seeking local care.
Overall, women living in maternity care deserts travel about three times farther for labor and delivery services than those in counties with full care access.
The report notes that longer travel distances correlate with higher rates of delayed prenatal care, higher rates of maternal morbidity, increased admissions to neonatal intensive care units, and more unplanned births occurring outside of hospitals.
“Across the country, families continue to face unnecessary barriers to maternity care with shifting healthcare and policy decisions threatening to widen gaps and weaken essential services,” said Cindy Rahman, President and CEO of March of Dimes.
The report also highlighted geographic disparities in healthcare access. More than half of all U.S. counties have no hospital offering labor and delivery services, a gap that affects roughly 370,000 births annually. Shortages of obstetric clinicians are more prominent in rural regions, where roughly 58% of counties lack an obstetric doctor, compared to 19% in urban counties.
Insurance coverage remains another factor. Nationally, about 1 in 9 women of childbearing age are uninsured, with the highest uninsured rates located in rural communities, the American South, and maternity care deserts. Since 2010, uninsured rates for women aged 19 to 54 dropped 45% nationwide under the Affordable Care Act, though states that did not expand Medicaid saw a smaller reduction of 35%.
“This year’s report is a stark reminder that maternity care deserts don’t happen by chance but are the result of deliberate policy choices that have left too many families without access to essential care,” said Dr. Michael Warren, Chief Medical and Health Officer at March of Dimes. “The health of moms and babies depends on the strength of the systems that support them, and that system is currently failing us.”
To address the disparities, March of Dimes outlined several ongoing efforts and proposed legislation. The organization highlighted support for the Rural Obstetrics Readiness Act, a bill reintroduced in Congress to fund emergency obstetric training for healthcare workers in rural settings.
The non-profit also currently operates seven mobile health units offering direct care in areas with limited access, including regions in Arizona, Ohio, Texas, New York, and Washington, D.C., with four additional units planned for Alabama, Illinois, and Ohio. Additional initiatives mentioned in the report include a five-year workforce program with the CVS Health Foundation to expand access to doula services, alongside guaranteed income pilot projects operating in New Orleans, Atlanta, and Michigan aimed at helping low-income mothers cover basic living costs.
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