What you probably already know: Giving birth across vast stretches of both the American heartland and the rural West now requires a serious road trip. More than one-third of all counties across the United States, 34.6%, qualify as maternity care deserts, according to a March of Dimes report, “Nowhere to Go: Maternity Care Deserts Across the U.S.” More than 2.4 million women of reproductive age — defined by the World Health Organization as between the ages of 15 and 49 — and nearly 149,000 newborn babies now live in areas with no hospitals or birth centers offering obstetric care and no obstetric clinicians. Between 2024 and early 2026 alone, at least 96 labor and delivery units closed across 35 states, and in nearly 60% of those counties, the closure was the sole remaining birth facility.
Why it matters: Latasha Bell, who lives in rural Alabama, had to drive 45 minutes to the nearest hospital to give birth. When she went into labor, doctors determined she wasn’t ready to give birth yet and sent her home. Rather than drive back, she and her husband decided to stay at a nearby hotel. She returned to the hospital an hour later to give birth to her daughter, Kylen, who had trouble breathing and wound up in the neonatal intensive care unit. “If I had delivered at home, would I even have her with me right now,” Bell asks. As March of Dimes President and CEO Cindy Rahman notes, “Every family deserves access to high-quality maternity care, no matter where they live.”
What it means: The South and Midwest have the most maternity care deserts, though in Mississippi, West Virginia and North Dakota up to 20% of women and infants lack access to services. The states of North Carolina, Texas and Tennessee together account for more than 1.2 million women and 82,000 infants living in areas with limited access. Maternity care deserts are rural, have lower median incomes and higher rates of uninsured women. All told, 5.8 million women and 358,000 infants have limited access to maternity care. The report notes that cuts in Medicaid and Medicare “threaten to reverse progress.”
What happens next: “It’s scary to think that if our clinic were not there, where would they go?” says Dr. Jamie Bishop, a family physician at Cahaba Medical Care in Centreville, Alabama. “Families in rural communities deserve the same opportunity for healthy pregnancies and healthy babies as anyone else.” The March of Dimes notes that expanding access to midwives would help tremendously, including authorizing them to prescribe medication, admit and discharge patients and reimburse them at 100% of physician rates. Colorado, Washington, D.C., Maine and Rhode Island are all states with supportive midwifery policies. What gives me hope,” says Dr. John Waits, co-founder and CEO at Cahaba Medical Care, “is that there is a new generation of physicians who want to care for families in rural communities.”
