Maternity Care Deserts
Counties with no hospital or birth center offering obstetric care and no obstetric providers, leaving pregnant people without local maternity services.
SDG 3 Good Health & Well-beingSDG 5 Gender EqualityWhat is it?
A maternity care desert is a county with no hospital or birth center offering obstetric care and no obstetric providers. March of Dimes estimates that over a third of U.S. counties are maternity care deserts, affecting millions of women of reproductive age.
Why does it matter?
Distance from obstetric care is associated with more out-of-hospital and preterm births and worse maternal and infant outcomes. The United States already has high maternal mortality relative to peer nations, and rural closures widen the gap.
How does it work?
When rural hospitals close or shed their obstetric units — which are expensive and low-margin to staff around the clock — the nearest delivery site can become an hour or more away, and prenatal care becomes harder to sustain.
Who benefits?
No group benefits from a desert itself; consolidating deliveries into well-staffed regional units can improve safety for complex births when transport and prenatal support are reliably provided.
Who may be disadvantaged?
Rural pregnant people, disproportionately low-income and from communities of color, who face longer travel, missed prenatal visits, and higher risk during labor emergencies.
What evidence exists?
March of Dimes maps deserts and access nationally; GAO reports document declining hospital-based obstetric care in rural areas and its association with reduced access to timely delivery.
What tradeoffs exist?
Regionalizing high-risk obstetric care can raise clinical quality but imposes heavy travel and cost burdens; keeping every small unit open is often financially and safely impractical.
Common misconceptions
A maternity desert is not defined by the absence of any care at all — a county can have general clinicians yet still lack any obstetric provider or delivery facility, which is what the metric captures.
What you can do next
See how these deserts stem from broader hospital closures and provider shortages, and how telehealth and rural clinic models attempt to sustain prenatal access.