A new report from the March of Dimes paints a stark picture of ongoing maternal health access challenges in the United States. The report, entitled Nowhere to Go: Maternity Care Deserts in the US, states that over 35% of U.S. counties are classified as maternity care deserts, leaving more than 2.3 million women of reproductive age without adequate access to obstetric care. These regions, often in rural areas, face a combination of hurdles, including workforce shortages and a lack of essential healthcare infrastructure. The ripple effects are clear: maternal and infant health outcomes in these underserved regions significantly lag behind those in more urban settings.
Key findings from the March of Dimes report:
- 35% of U.S. counties are classified as maternity care deserts, affecting over 2.3 million women of reproductive age.
- An additional 3 million women live in counties with limited access to maternity care.
- Approximately 350,000 babies were born last year in counties with limited or no access to obstetric services.
- Over half of all U.S. counties lack a hospital that provides obstetric care.
- The infant mortality rate increased significantly in 2022 for the first time in 20 years.
The conversation surrounding maternal health access often focuses on the shortage of OB/GYNs, but Dr. Mark Simon, Chief Medical Officer at Ob Hospitalist Group (OBHG), suggests it might be time to rethink this narrative. “Does the U.S. have an OB/GYN shortage, or does the U.S. have a midwife shortage and a misallocation of clinical resources?” he recently commented, referencing an international comparison between the U.S. and other developed countries. While the number of OB physicians per 1,000 live births is similar to nations like Norway, France, Sweden, and others, the U.S. has a significantly smaller proportion of midwives by comparison. Dr. Simon’s observation suggests that expanding the use of CNMs could be a key strategy in addressing maternal care gaps in the U.S. This perspective is further supported by the March of Dimes report’s finding that only 27 states, along with the District of Columbia, grant full practice authority to CNMs.
How Ob Hospitalist Group is working to bridge the gaps in maternal health access
These statistics highlight not only the scope of the problem but also the need for innovative solutions like OBHG’s Maternal Health Access Solutions (MHAS) programs. MHAS is designed to offer flexible and scalable models that integrate both CNMs and OB/GYN physicians into underserved rural communities. By doing so, the program helps hospitals maintain their labor and delivery units, providing comprehensive care to women who might otherwise face lengthy commutes or lack of access to critical services. MHAS helps ensure these hospitals remain viable, preventing the closure of essential maternity services.
Dr. Amy VanBlaricom, Chief Clinical Officer at OBHG, emphasized the importance of these programs, noting, “At OBHG, our mission is to provide equitable care for all women, regardless of their location or background. Addressing areas with limited access to maternal healthcare is a key part of fulfilling that mission. Through MHAS programs, we can help hospitals stay open and keep their maternity units running by providing the staffing solutions they need, whether that’s full-scope practitioners or a creative, integrated model with midwives and OB/GYNs. We work closely with each hospital to tailor a care model that meets both the community’s and hospital’s unique needs.”
Incorporating CNMs into the care model ensures that midwives can handle routine deliveries and prenatal care, freeing OB/GYNs to focus on more complex cases. This strategic allocation of resources ensures that care is delivered where it is needed most, by the appropriate professionals. In doing so, MHAS fills critical gaps in underserved areas, ensuring that even vulnerable populations receive timely, high-quality care from the right provider at the right time.
Moreover, MHAS extends its impact beyond just staffing solutions. By offering expanded clinic hours and flexible care options, MHAS ensures that women—particularly those with limited transportation or busy work schedules—can access the care they need. This holistic approach helps ensure that no woman in a limited-access area is left behind, giving her access to the necessary care throughout pregnancy, childbirth, and the postpartum period.
In the face of the issues highlighted by the March of Dimes report, programs like OBHG’s Maternal Health Access Solutions offer a critical path forward. By integrating certified nurse midwives and OB/GYNs into underserved communities, MHAS provides a sustainable model for ensuring that every woman has access to the care she needs, no matter where she lives. This innovative approach helps bridge the gap in maternal healthcare and improves outcomes for women and their families across the country.