Mother Of A Problem – Access To Maternal Care Is Declining Across The United States

When we look at the state of maternal care in the United States, a country that spends more on healthcare than any other nation, the natural assumption would be that we are ahead of the pack with great policies and health outcomes. Unfortunately, the opposite is true. And in a nation that has no federal paid leave policy, with a rising maternal mortality rate, the cost of childcare placing increasing financial burdens on parents, and a recent report from the U.S Surgeon general outlining that parenting is so stressful and debilitating in this country that it has become an urgent public health issue, it is clear something drastic needs to change.

In a country that is about to elect a new President who could be responsible for either taking us forward on healthcare or backward, it is also vital that we acknowledge the elephant in the room – abortion rights. Since Roe v Wade was overturned in a U.S. Supreme Court decision in 2022, it is not only access to safe abortion care that has been decimated, but the knock-on effect to a person’s ability to access maternal care has become extremely difficult in a number of states, and even deadly.

What are the long-term implications on mothers and families when maternal care is not prioritized? And how do we build new models of care that are patient and community centered, which can help tackle our growing problem? March of Dimes has just released a new report diving into why access to maternity care in the U.S. is declining, and the stats are alarming.

Quick findings from the report show: 

  • 1 in every 25 obstetric units in the U.S. closed in the last 2 years. 
  • More than 35% of counties in the U.S. are considered maternity care deserts. This means that in 1,104 US counties, there is not a single birthing facility or obstetric clinician, leaving over 2.3 million women of reproductive age without access to care. 
  • Over 1 in 3 U.S. counties lack a single obstetric clinician, and in many parts of the country OB-GYNs and family physicians who deliver babies are leaving the workforce.

To learn how this lack of access is impacting overall maternal care in the U.S., we had the opportunity to speak with Amanda Minimi, Director at Aeroflow Health, which provides maternal resources to mothers through insurance. She enlightened us about a term we’ve seen popping up in a number of articles, “maternity deserts”, why so many OB-GYNs are leaving the workforce, and why we must also look at this problem with an intersectional lens.

Amanda Minimi, Director of Aeroflow

Looking at the new March of Dimes report about the state of Maternal Care in the U.S right now, it feels like we have a lot to be alarmed about. Why should more people be paying attention to this data? 

More people should pay attention to the new March of Dimes report on maternal care because it highlights urgent issues that affect the health and well-being of families across the country. Rising rates of maternal and infant mortality are alarming indicators of a public health crisis that demands immediate action. This isn’t just a statistic; it’s about real lives and the futures of mothers and their babies.

The report highlights significant disparities in access to care, especially in rural and underserved communities, where many women are not receiving the support they need, resulting in poorer health outcomes. Additionally, it reveals systemic issues like racism within the healthcare system that negatively impact birth outcomes based on race and ethnicity. By raising awareness and advocating for policies that promote equitable access to quality care, we can work towards addressing these inequities and creating a fairer healthcare environment for all families.

Ultimately, this report is a call to action. By understanding these challenges, individuals and communities can engage in meaningful conversations and push for the necessary changes in policy and support systems. Ignoring these issues only perpetuates the crisis; we need collective awareness and action to drive real improvements in maternal health.

In the last 2 years, 1 in every 25 obstetric units has closed across the U.S. This also coincides with the fact that Roe v Wade was overturned 2 years ago, and we still have the highest rates of maternal mortality in the developed world. Can you explain a little more the far-reaching impact of obstetric units shutting down? 

The closure of obstetric units across the U.S. in the past two years has serious implications for maternal health, significantly limiting patients’ access to life-saving and critical services. With 1 in every 25 units shutting down, many expectant mothers now face greater barriers to care, which exacerbates the already high rates of maternal mortality in the developed world. This situation often means longer travel times to reach the nearest facility, increasing the risk of delayed or missed care that jeopardizes the health of both mothers and their babies.

For physicians who remain in practice, the situation is equally challenging. They are grappling with heightened demands and responsibilities, which now include extensive clinical documentation to satisfy insurance requirements, navigating staffing shortages, and providing a range of support services, such as lactation and doula assistance. This added pressure can lead to burnout among healthcare providers, ultimately diminishing the quality of care they can offer. Together, these challenges create a difficult environment for both patients and healthcare workers, underscoring the urgent need for effective solutions to address the ongoing crisis in maternal care.

For folks who aren’t familiar with the term, what is a “Maternity Desert”, and why is it a cause for alarm? 

A “maternity desert” describes areas, often rural or underserved, where access to maternity care services is alarmingly inadequate—counties without a single obstetrician, midwife, or hospital providing obstetric care. This situation is deeply concerning for many reasons. Residents in these deserts often face the daunting reality of traveling over an hour just to reach the nearest facility for prenatal, delivery, and postpartum care. This distance can delay critical care, especially in emergencies when every minute counts.

Living in a maternity desert is linked to higher rates of preterm births and serious complications, as the lack of timely healthcare can exacerbate health issues for both mothers and their infants. The impact is even more devastating for marginalized communities, where maternal and infant mortality rates soar, revealing systemic inequities in healthcare access and quality. Economic barriers add another layer of difficulty; many women simply can’t afford the travel necessary to access care, leaving them vulnerable and without essential services.

The absence of local maternity care doesn’t just affect individuals—it strains entire communities, leading to greater reliance on emergency services and poorer health outcomes for future generations. We must urgently address the crisis of maternity deserts to ensure that every person has equitable access to safe, compassionate maternity care. Together, we can improve health outcomes for mothers and their babies and create a healthier future for our communities.

Why are so many OB-GYNs and family physicians who deliver babies leaving the workforce? 

Many OB-GYNs and family physicians who deliver babies are leaving the workforce, and the reasons behind this trend are deeply concerning. These dedicated professionals face overwhelming challenges, from long hours and high patient loads to the emotional strain of managing complex cases. On top of this, environmental factors like declining reimbursement rates, increased expectations around the provision of care, and rising costs of malpractice insurance create an atmosphere of anxiety that makes it difficult for them to continue.

The burden of extensive administrative tasks only adds to the stress, as many physicians find themselves spending more time on paperwork than with their patients. This shift leads to frustration and burnout, making it hard for them to maintain their passion for providing care. For those in rural or underserved areas, the pressure is even greater, as they juggle multiple roles in an already strained healthcare system.

It’s heartbreaking to see compassionate, skilled providers feeling pushed out of their profession, leaving families without the essential care they need. We urgently need to create a more supportive environment for these physicians, ensuring they have the resources and complementary services they need, while allowing them to operate at the highest level of their license—ultimately supporting the health and well-being of both mothers and their babies.

As we are in a moment of crisis, what are some important resources you can recommend families and communities seek out to ensure proper maternal support? 

In this moment of crisis, it’s crucial for families and communities to seek out a variety of resources to ensure proper maternal support. First and foremost, connecting with local maternal health organizations can provide vital information about available services, including prenatal and postpartum care, mental health resources, and community support groups.

Additionally, many areas offer complementary care services such as lactation consultants, doulas, and midwives who can provide personalized support during pregnancy and after childbirth. Building a strong support network, or “village,” early on can make a significant difference in a mother’s experience.

Telehealth is also a valuable option to consider; it can bridge the gap for those facing barriers to in-person visits, offering convenient access to healthcare professionals for consultations, education, and follow-up care. By exploring these resources and utilizing a combination of in-person and virtual support, families can ensure that mothers and babies receive the comprehensive care they need during this critical time.

From your perspective, what are some ways the healthcare system needs to change to address the maternal care crisis? 

There is no single solution to the maternal care crisis, but we cannot afford to dismiss the challenges and do nothing. To tackle this urgent issue, we must adopt a collaborative and population health-based approach. Each maternity desert needs to be assessed for its unique needs to increase the number of available providers. In the meantime, enhancing access to telehealth services can help bridge critical gaps in care.

It’s essential to implement more screening processes and foster community support around mothers, creating networks that empower and uplift them. We must also identify the specific barriers families face in accessing care and use that information to shape care teams that truly meet each mother’s needs. By taking these compassionate steps, we can work towards a more equitable and effective maternal healthcare system that ensures every mother receives the care she deserves.

It’s also important to note that the people primarily impacted by maternal care deserts are typically Black and Brown families, low-income families, people with disabilities, immigrants, and young mothers. Why is it vital that we tackle this issue with an intersectional lens and understand how different communities are impacted? 

It’s crucial to address maternal care deserts through an intersectional lens because the families most affected are often Black and Brown families, low-income households, people with disabilities, immigrants, and young mothers. These communities already face systemic inequities that exacerbate their challenges in accessing quality care. By understanding how different factors—such as race, socioeconomic status, disability, and immigration status—intersect, we can better identify the unique barriers each group faces and tailor our solutions accordingly.

For instance, Black and Brown families often experience higher rates of maternal mortality due to historical and ongoing disparities in healthcare access and treatment. Low-income families may struggle with transportation and childcare, while immigrants might face language barriers and fears related to their legal status. Young mothers, who may lack support systems, also require targeted resources to navigate pregnancy and parenting.

By tackling the issue with this nuanced understanding, we can develop comprehensive strategies that not only improve access to care but also address the underlying social determinants of health. This approach ensures that all families receive the compassionate and equitable support they need, ultimately leading to better health outcomes for mothers and their babies across all communities.

When we look at the way the U.S is so far behind on a number of issues that impact women primarily – childcare, reproductive health, the wage gap, paid leave and even sex education, it’s clear these are all interconnected to the maternal care crisis. What kind of message do you think a country sends when it doesn’t prioritize these issues, that aren’t just “women’s issues” but important family and community issues? 

When the U.S. fails to prioritize issues like childcare, reproductive health, the wage gap, paid leave, and comprehensive sex education, it sends a clear message that the well-being of families and communities is not a national priority. This neglect reinforces the idea that these challenges are merely “women’s issues,” rather than recognizing them as critical components of a healthy society. By not addressing these interconnected concerns, the country essentially undermines the stability and health of families, perpetuating cycles of inequality and hardship.

This lack of support can lead to increased stress for parents, particularly mothers, who are already navigating the complexities of raising children. It signals to families that their needs are not valued, which can erode trust in the systems designed to support them. Moreover, it contributes to a culture that views maternal care as an afterthought, rather than a fundamental aspect of community health.

By prioritizing these issues, we can create a more supportive environment for all families, recognizing that the well-being of mothers directly impacts the health of children and, by extension, entire communities. When we treat these challenges as interconnected and essential, we take meaningful steps toward fostering a society that values and uplifts every individual.

What are some small, everyday ways each of us can push for change when it comes to maternal care, regardless of our status, finances, geographical location etc? Can you give us some examples?

There are many small, everyday ways we can push for change in maternal care, regardless of our status or location. Start by raising awareness in your community—share information on social media or host discussions about maternal health challenges. Support local organizations by volunteering or donating to initiatives that assist mothers and families.

With the upcoming election, leverage this opportunity to express that maternal care is important to you; advocate for policies like paid family leave and better access to childcare. Engage in community support by creating or joining local groups for expecting and new parents, and educate others about maternal health issues.

Utilize telehealth options to improve access to care, especially in underserved areas, and support women-owned businesses that provide maternity services. Share your personal experiences to highlight the challenges many face, and be an ally by amplifying the voices of marginalized communities.

By taking these impactful steps, especially during election season, we can advocate for better maternal care and support the health and well-being of families in our communities.


You can see more data from the full March of Dimes report. And head over to the Aeroflow Health website to find maternal care resources that can support your journey.