Happy expectant woman touching belly, enjoying unborn baby pushings in bed, side view
More than one-third of U.S. counties have significant maternity care access gaps, according to a March of Dimes report released Tuesday.
The report found that 34.6% of U.S. counties are currently “maternity care deserts,” home to 2.4 million women of reproductive age and where 149,000 infants are born each year. Women who live in such “deserts”— many of which are in rural areas of the country — travel roughly three times farther to obtain labor and delivery services on average than those living in counties with broader maternity care access.
An additional 3.4 million women and 209,000 infants presently live in U.S. counties that have “low or moderate” maternity care access, according to the report. Meanwhile, over half of U.S. counties do not have a hospital with labor and delivery services, which impacts nearly 370,000 births per year.
“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,” March of Dimes President and CEO Cindy Rahman said in a statement. “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.”
The report also found that obstetric clinician shortages are worse in rural regions of the U.S., where almost 58% of counties do not have obstetric clinicians, compared with about 19% of urban counties. Moreover, an estimated 96 publicly reported labor and delivery unit closures occurred across 35 U.S. states between January 2024 to May 2026, March of Dimes reported.
“This year’s report is a stark reminder that maternity care deserts don’t happen by chance but are the result of deliberate policy choices that have left too many families without access to essential care,” March of Dimes Chief Medical and Health Officer Dr. Michael Warren said in a statement. “The health of moms and babies depends on the strength of the systems that support them, and that system is currently failing us.”
“However, the solutions are within reach, and they require coordinated action from healthcare providers, policymakers, employers, and communities,” Warren added. “We cannot solve this crisis alone.”
About 1 in 9 women who are of reproductive age are uninsured across the nation, with the highest amount located in the South, rural areas and maternity care deserts, according to March of Dimes’ estimates.
The new report comes as many rural hospitals in the U.S. have reportedly stopped providing delivery services. Since the end of 2019, 139 rural U.S. hospitals have either stopped delivering babies or intend to do so by the end of 2026, marking a 13% drop in rural labor and delivery units, according to estimates from Becker’s Payer Issues.
Women residing in rural areas of the country often face hurdles such as limited access to maternity care, reproductive health services, postpartum support and paid leave, per the Rural Health Information Hub.
Scarce maternal healthcare in the nation’s rural areas can also lead to issues such as premature birth, low birth weight, maternal and infant morbidity and mortality and heightened risk of postpartum depression, according to a September 2022 article published in the National Library of Medicine.
Additionally, surging maternity care costs in recent years have created major financial challenges for many U.S. women. A KFF analysis released in September 2025 found that medical costs related to pregnancy, childbirth and postpartum care in the U.S. totaled $20,416 on average for women enrolled in employer plans.
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