The state of women’s health in the United States is under threat, exacerbated by the proliferation of maternity care deserts and the ramifications of the Roe v Wade decision reversal. According to estimates by the Center for Healthcare Quality and Payment Reform, 55% of rural hospitals in the US lack labor services, leaving women to endure extensive journeys to access birthing facilities.
While the rural-urban divide is a significant factor in accessing women’s health services, with rural residents often facing journeys of thirty minutes or more to reach the nearest maternity wards, other dynamics are also contributing to the crisis. Investigations conducted in counties with predominantly Black populations reveal that Black women in rural areas are disproportionately affected. During a webinar organized by the Center for Health Journalism (CHJ), it was highlighted that rural Black women are three times more likely than rural white women to die from pregnancy-related causes.
The lack of proximity to hospitals with dedicated obstetrics and gynecology departments affects most pregnant women living outside urban areas. Approximately 2 million women must travel at least 40 kilometers before reaching the nearest such services. However, as underscored by reporters Nada Hassanein and Margo Snipe during the CHJ discussion, the distance becomes even more daunting for women facing pregnancy complications requiring specialized care.
Maternity services encompass not only labor wards, which have experienced numerous closures in rural regions in recent decades, but also prenatal, perinatal, and postpartum care. With gynecological wards often two hours away, many women are forced to forgo essential consultations, increasing their risk of developing health issues with long-term repercussions for both themselves and their children.
Towards the end of last year, the Centers for Disease Control (CDC) reported a 3% rise in the infant mortality rate for 2022, along with an increase in cases of congenital syphilis in babies, representing a tenfold surge compared to a decade ago. Alarmingly, it was estimated that approximately 90% of these cases could have been addressed during antenatal visits, yet 40% of pregnant women infected with syphilis did not receive this vital care.
Maternity care deserts also impede successful breastfeeding initiation and continuation, with mothers in such areas less likely to breastfeed successfully. Research conducted by Channel Haley and colleagues in Louisiana demonstrated lower breastfeeding rates associated with maternity care deserts, with Black mothers disproportionately affected once again.
The deficiency of maternity care services in rural America has persisted as a longstanding issue. Public health officials and journalists advocating for change warn that the problem will persist without concerted efforts at the state and federal levels to enhance access to care. This includes expanding Medicaid benefits for new parents and bolstering the healthcare workforce by recruiting more midwives and gynecologists.
At present, these pleas have largely gone unheeded. Instead of prioritizing equitable access to healthcare nationwide, authorities continue to neglect rural health services, leaving them vulnerable to further closures.
