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The Ongoing Crisis of Maternal Care Deserts in the U.S.

In recent years, the United States has faced a growing crisis that threatens the health and wellbeing of mothers and babies: the rise of maternal care deserts. A maternal care desert (MCD) is defined as a county in which access to maternity health care services, including hospitals or birth centers with obstetric care, OB/GYNs, and certified nurse-midwives, is significantly limited or entirely absent (CITATION). These areas, often rural and underserved, lack the necessary resources to provide adequate prenatal, birth, and postpartum care, posing severe risks to maternal and infant health.

The emergence of MCDs is not a new phenomenon but has been increasingly highlighted as a critical public health issue over the last few decades. The roots of this crisis can be traced back to the early 2000s, as rural hospitals began to close their maternity wards or shut down entirely due to financial pressures, staffing shortages, and declining birth rates in rural areas. This trend has led to a significant portion of the population living in areas where maternal and obstetric care is scarce or non-existent, forcing expectant mothers to travel long distances for care or completely forego vital services altogether.

The March of Dimes, a leading nonprofit organization focused on maternal and baby health, has been at the forefront of researching and bringing attention to this issue. Their 2023 report on maternal care deserts on the United States provides a comprehensive analysis of the scope and impact of these MCDs on families and communities. According to the report, over 5 million women of childbearing age live in an area that qualifies as a MCD, highlighting the widespread nature of the problem.

The consequences of living in a MCD are dire. Women in these areas face higher risks of maternal morbidity and mortality, premature births, and low birthweight babies. Lack of access to regular prenatal care means potential complications may go undetected and untreated, leading to adverse outcomes for both mothers and their children. The March of Dimes report emphasizes that these issues disproportionately affect women of color, who are more likely to live in maternal care deserts and face additional systemic barriers to healthcare access. Read more on the impact of race on maternal morbidity.

Efforts to address the crisis of MCDs have included policy initiatives at both the federal and state levels, aiming to improve access to care in underserved areas. Strategies such as expanding Medicaid coverage for postpartum care, increasing funding for rural hospitals, and supporting telehealth services have been proposed and implemented in various locales. However, the persistence and complexity of the issue demand continued attention and innovative solutions.

One promising approach to mitigating the impact of maternal care deserts is the expansion of midwifery and doula services, which can provide critical support to pregnant women before, during, and after childbirth. These professionals can help bridge the gap in care, especially in areas where traditional obstetric services are not available. Additionally, community-based initiatives that offer transportation, education, and support services can play a vital role in improving outcomes for mothers and babies.

The March of Dimes 2023 report calls for a multi-faceted response to the MCD crisis, including increased investment in healthcare infrastructure, targeted support for vulnerable populations, and the promotion of policies that ensure all women have access to high-quality maternal care. The report underscores the importance of data collection and research to better understand the needs of communities living in maternal care deserts and to monitor the effectiveness of interventions.

As we look to the future, addressing the crisis of MCD in the U.S. requires a collective effort from government, healthcare providers, community organizations, and advocates. By working together to increase access to care, improve the quality of services, and support the health and wellbeing of mothers and babies, we can begin to close the gaps in our healthcare system and ensure that every family has the support they need during one of the most important times of their lives.

The issue of MCD is an evolving and complex challenge that reflects broader systemic issues within the U.S. healthcare and social support systems. The March of Dimes 2023 report serves as a crucial call to action, highlighting the urgent need for comprehensive strategies to address the disparities in maternal health care. As a society, we must prioritize the health of mothers and their babies, ensuring that geography does not determine the quality of care and support that every family deserves.

For the most accurate and up-to-date information, please refer to:

- March of Dimes official website and their annual reports on maternal and infant health in the U.S. (https://www.marchofdimes.org/)

- Peer-reviewed articles and health policy research journals for detailed studies on the impact of maternal care deserts

- U.S. Centers for Disease Control and Prevention (CDC) for data on maternal mortality and morbidity, and the effects of limited access to care.

Definitions

Morbidity: Refers to having a disease or a symptom of disease, or to the amount of disease within a population. Morbidity also refers to medical problems caused by a treatment.

Mortality: The number of deaths that occur in a population.

Low Birthweight Babies: Babies who are born weighing less than 2,500 grams (5 pounds, 8 ounces).

Postpartum: Postpartum care or postnatal care is a service provided to individuals in the postpartum period, to help with postpartum recuperation and restoration. The comprehensive postpartum visit should include a full assessment of physical, social, and psychological well-being, including the following domains: mood and emotional well-being; infant care and feeding; sexuality, contraception, and birth spacing; sleep and fatigue; physical recovery from birth; chronic disease.

Premature Birth: A birth that takes place too early, before the 37th week of pregnancy.

Prenatal: Prenatal care is medical care you get during pregnancy

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