A recent March of Dimes report spotlighted persistent maternity care deserts across the US, driven by workforce shortages and hospital closures.
With one-third of US counties considered maternity care deserts – counties without a birthing hospital, birth center, or obstetrician – 2.4 million women of reproductive age and nearly 149,000 births are in areas without full access to maternity care. Meanwhile, 5.8 million women and 358,000 infants live in counties with limited access, and more than half of US counties lack a hospital with labor and delivery services.
While 153 counties moved out of maternity care desert status between 2016 and 2024, 153 new deserts emerged, leaving the overall share largely unchanged. Texas saw the largest expansion, with 16 counties becoming maternity care deserts, while Iowa and Nebraska each added five.
Workforce shortages and closures are driving these gaps. Approximately 100 labor and delivery units have reported closures since 2024. Nearly two-thirds occurred in rural hospitals, while 58% involved the county’s only birthing facility.
Meanwhile, more doulas and midwives are entering the workforce, but regulatory, reimbursement, and institutional barriers continue to limit their integration into maternity care.
To address access gaps, the report points to telehealth and remote patient monitoring, mobile health, and expanded midwifery integration as potential solutions.
