Maternal Health Deserts in the United States: Solutions to Close Gaps, Improve Health

A study by March of Dimes suggests maternal health deserts impact millions of women living in the United States. 

In this interview, Patricia Carney, OBGYN, shares how these deserts affect women’s health and discusses how payers, providers, and other stakeholders across the country might consider tailoring solutions to close the gaps. 

What is the prevalence of maternal health deserts in the United States? What services might people go without if they live in a maternal health desert?

Nationwide, 36% of all US counties are maternity care deserts—areas that lack maternity care resources and have no obstetric providers or hospital or birth centers offering obstetric care. Approximately 2.2 million US women and almost 150,000 babies are affected by maternity care deserts, and 4.7 million women live in counties with limited maternity care access. Women living in maternity care deserts face significant challenges, including lack of access to important screenings before, during, and after pregnancy, which could put the health of women and their babies at risk. 

At one point, I practiced in one of these states where entire counties did not have a single OBGYN physician. Maternal health deserts are real and have very significant consequences.

How do barriers to maternal care impact patient outcomes, the health care industry, or society more generally?

Without adequate access to preconception, prenatal, and postpartum care, women living in maternal care deserts are at higher risk of complications such as preterm birth, complications during childbirth, or hemorrhage—and are even at increased risk of maternal mortality. And even outside of maternal health deserts, inequities in maternity care are prevalent, especially among women of color. 

For instance, 1 in 4 Native American women and 1 in 5 Black women did not receive adequate prenatal care in 2020, compared to only 1 in 10 White women. Additionally, Hispanic and Asian and Pacific Islander women were less likely than White women to receive adequate prenatal care (17.3 and 11.3%, respectively). These issues have all been exacerbated by the effects of the pandemic, including hospital closures, staffing shortages at health care facilities, and provider burnout.  

Despite the United States being one of the most developed nations in the world, we are in a maternal health crisis. In fact, the United States has the highest maternal mortality rate among comparable wealthy countries—and it continues to increase each year. These alarming statistics underscore a worrying trend of declining access to comprehensive reproductive care. This also contributes to broader consequences like increased medical costs, lost earnings and productivity for mothers, as well as long-term physical and mental health consequences for moms and babies. 

Considering that many women in the United States also face challenges accessing effective contraceptive care, these factors together highlight the urgent need to address maternal health deserts and improve the overall state of maternal health care in the United States. 

How can maternal health care access be improved?

Increasing access to quality maternal health care is a deeply rooted and complex issue—and while there is no “silver bullet” solution, I believe there are a few important avenues to pursue: 

• First, we need more investment in innovations that address significant gaps in women’s health. I’m encouraged that companies like Organon are focused on bringing forward innovations in areas like preterm labor (which impacts more than 15 million babies each year) and postpartum hemorrhage (one of the most common complications of childbirth). Women’s health still remains one of the most underfunded areas of health care research, so we need more organizations to join us who share the vision of a healthier every day for every woman. 
• We also need to expand equitable access to maternal care services. This could include putting in place incentives for more providers—whether OBGYNs, nurses, midwives, or doulas—to go into practice in rural areas or marginalized communities where maternal health deserts exist. It will take collaboration from businesses, policymakers, community leaders, and investors to support this work. 
• Last but certainly not least: data. While we’ve seen more efforts in recent years to measure maternal health disparities, there is still a large gap in information related to this topic. I’m a strong believer that what gets measured gets managed, as this is an important foundational step to better understanding the issues at play so that regulators, payers, and providers, as well as the public and private sector, can work together to tailor solutions to the needs of specific communities. 

Is there anything else you would like to add?

I want to highlight the powerful ripple effect that is created when we prioritize maternal health and women’s health overall. When there is a healthy ecosystem of research and innovation dedicated to improving women’s health and well-being, we see positive impacts for families, communities, economies, and society as a whole. That’s why I’m encouraged that we’re beginning to see more attention, dialogue, and investment in traditionally overlooked areas like contraception, fertility, and chronic conditions impacting women. 

No doubt, there is a long way to go to address the significant gaps that still exist today, but the progress we are seeing is promising, and I’m optimistic about the innovation we will see in the years ahead. 

About Dr Carney

Dr Patricia Carney is a board-certified OBGYN physician with broad clinical experience in women’s health. Among other things, she has served as a residency program director, assisting in the education of future OBGYN physicians; a national board examiner, involved with the specialty certification process of physicians; and the medical lead for a project providing obstetric and gynecological care to an entire state prison system. Over the past 12 years, Dr Carney has held roles in medical affairs, clinical development, and global safety within the pharmaceutical/device industry. She is currently the global strategic lead for maternal health within Organon, a position that has provided her with the opportunity to examine and work with maternal health care delivery in the United States and throughout the world.