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March of Dimes: Maternity care deserts impact 2.4M women

March of Dimes said labor and delivery unit closures led to widespread maternity care deserts and healthcare access issues.

Sara Heath
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Published: 17 Aug 2026

The U.S. is staring down a mounting maternity care desert problem, threatening patient access to care and maternal health outcomes for millions of women nationwide, according to the latest from March of Dimes.

The biannual report, "Nowhere to Go: Maternity Care Deserts Across the U.S.," outlines the state of maternity care access. This year, March of Dimes reports that about a third (34.6%) of U.S. counties are maternity care deserts, defined as having no obstetric clinicians or birthing facilities.

The nation's maternity care deserts are home to 2.4 million women of reproductive age and are where 149,000 infants are born annually, potentially threatening healthcare access and birthing outcomes for these individuals.

"Across the country, families continue to face unnecessary barriers to maternity care with shifting healthcare and policy decisions threatening to widen gaps and weaken essential services," Cindy Rahman, president and CEO of March of Dimes, said in a press release.

"Now is the time to reimagine what maternity care can and should be by building a system that creates healthier beginnings, stronger communities, and better outcomes for generations to come. March of Dimes remains committed to that transformation, and by working together, we can build a future where every family has access to the care they need."

Patients aren't just contending with full maternity deserts, the report found. Another 3.4 million women and 209,000 infants live in counties with low or moderate access to maternity care, which can also lead to provider shortages and make it hard to access care.

Perhaps unsurprisingly, these problems are worse in rural areas, with more than half (58%) of rural counties lacking obstetric clinicians compared with 19% of urban counties.

These problems are driven by a number of trends, not least of which includes maternity ward closures.

Between January 2024 and May 2026, there were at least 96 publicized labor and delivery unit closures across 35 states. In nearly 60% of affected counties, the labor and delivery unit that closed was the only local birthing facility. This leaves more than half of U.S. counties lacking a hospital with labor and delivery services, affecting 370,000 births each year.

Ultimately, labor and delivery unit closures increased the average travel time to 25 minutes in affected communities. Women in maternity care deserts travel about three times further than those in counties with full maternity care access, the report authors added.

Long travel times have consequences for healthcare access and quality, including delayed access to prenatal care, greater odds of unplanned out-of-hospital deliveries, higher rates of maternal morbidity and higher neonatal intensive care unit admissions, March of Dimes said.

Longer travel times are also linked to higher costs for families due to transportation, childcare, missed work and temporary lodging.

Uninsurance necessitates policy change, community support

This year's report also examined insurance coverage among women of reproductive age. After all, having adequate insurance coverage can influence an individual's maternity care access. Those who are uninsured might not access prenatal or other types of maternity care, adversely affecting outcomes.

All said, about 1 in 9 women of reproductive age are uninsured nationwide, March of Dimes said. Uninsurance is most common in the South, rural areas and maternity care deserts.

In other words, in the places where it's already hard to find a maternity care provider, many people also lack insurance coverage for the services. This comes even as the uninsured rate among women aged 19-54 dropped 45% since the ACA's enactment in 2010.

"The health of moms and babies depends on the strength of the systems that support them, and that system is currently failing us," Michael Warren, chief medical and health officer at March of Dimes, said in a press release. "However, the solutions are within reach, and they require coordinated action from healthcare providers, policymakers, employers, and communities. We cannot solve this crisis alone."

Foremost, it will be essential to assess the implications of new policies that might affect insurance coverage or access to maternity care. This includes those affecting Medicaid expansion states and states that have extended postpartum Medicaid coverage, March of Dimes recommended.

Likewise, March of Dimes endorsed the Rural Obstetrics Readiness Act, which was recently introduced in Congress. The organization said the bill would enable provider training focused on obstetric emergencies during pregnancy, labor and delivery and the postpartum period.

Next, the group urged better care access through mobile health clinics. March of Dimes has sponsored some of this work by deploying seven units across the U.S.

Additionally, March of Dimes called for expanded access to doulas for community-based birthing support.

Finally, March of Dimes called for programs that help address social determinants of health, which have an outsized impact on maternity care outcomes. The group specifically highlighted guaranteed income programs in New Orleans, Atlanta and Michigan.

Sara Heath is an executive editor at Xtelligent Healthcare Media, where she covers patient engagement, healthcare policy and health IT.

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