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Nowhere to go: Maternity Care Deserts across the US 2024 Report for

The cover of the Maternity Care Deserts report.

Download the full report as a PDF in English, Spanish, read the Executive Summary or Technical Notes.

Ensuring consistent, high-quality maternity care is essential to safeguard the health of pregnant people and the 3.6 million babies born each year in the US. In addition to the over 800 maternal deaths that occur each year, the infant mortality rate increased significantly in 2022 for the first time in two decades. With adequate access to timely and appropriate care, many of these deaths are preventable.

Nowhere To Go: Maternity Care Deserts Across the US (2024 report) continues to expand education and awareness about areas without access to care. By diving into data and explaining barriers that keep women with too few options, knowledge becomes the catalyst for action. The report examines how factors like fertility rates, chronic disease and social drivers of health (SODH) influence access to care and for the first time, maternity care access and its association with birth outcomes are examined. Policy actions and recommendations that can improve access to care are also incorporated throughout the report.

Key Findings

Key Finding 1
Key Finding 2
Key Finding 3
Key Finding 4
Key Finding 5

Components of access

This report explores access to maternity care within the context of healthcare access, defined as the “timely use of personal health services to achieve the best possible health outcomes”. 1

While not exhaustive, the figure below illustrates the key factors affecting maternity care access analyzed throughout this report. Each segment examines specific topics, incorporating recent data, and exploring the influence of state and federal policies and social drivers of health (SDOH). This report aims to highlight the challenges in ensuring that everyone has equitable and timely access to maternity care.

Key factors affecting maternity care access

Components of access
Interactive maps can be found in the sections below. Click the section titles in the map legend to hide or reveal sections and filter your view. Hover (on desktop) or tap (on mobile) on each county on the map for more specific information.
  1. Maternity Care Deserts

    March of Dimes maternity care access designations are based on 3 factors: the ratio of obstetric clinicians to births, the availability of birthing facilities, and the proportion of women without health insurance. Each county is classified into 1 of 4 categories: full access, moderate access, low access, or maternity care desert.

    Maternity care access designations

    • * Obstetric clinicians include obstetricians-gynecologists (OB-GYNs), certified nurse-midwives (CNMs), certified midwives (CMs), and family physicians who reported delivering babies.
    Definitions
    (Click to sort ascending)
    Maternity care desert
    (Click to sort ascending)
    Low access
    (Click to sort ascending)
    Moderate access
    (Click to sort ascending)
    Full access
    (Click to sort ascending)
    Hospitals and birth centers offering obstetric care
    zero
    <2
    <2
    >=2
    Obstetric clinicians per 10,000 births*
    zero
    <60
    <60
    >=60
    Proportion of women 18-64 without health insurance
    any
    >=10%
    <10%
    any
    • Over one third (35.1%) of counties in the US are considered maternity care deserts, areas without a single birthing facility or obstetric clinician.
    • Roughly 1 in 10 birthing people reside in counties without full access to maternity care.
    • Approximately 1 in 5 births among American Indian/Alaska Native women were to those living in counties without full access.
    • Nearly two thirds of maternity care deserts are rural.

    States with the highest percent of maternity care deserts

    Notes: From left to right - top row: North Dakota, South Dakota, Oklahoma; bottom row: Missouri, Nebraska, Arkansas.

  2. Outcomes in maternity care deserts
  3. Availability of obstetric hospitals and birth centers
  4. Availability of obstetric clinicians
  5. Health insurance coverage
  6. Travel time to care
  7. Fertility rates
  8. Chronic conditions
  9. Social drivers of health
  10. Policy solutions and actions
  11. Conclusions
  12. References

Suggested Citation

Stoneburner A, Lucas R, Fontenot J, Brigance C, Jones E, DeMaria AL. Nowhere to Go: Maternity Care Deserts Across the US. (Report No 4). March of Dimes. 2024. https://www.marchofdimes.org/maternity-care-deserts-report