A Growing Maternity Care Crisis

Jocelyn Doan

What are maternity care deserts?

Maternity care deserts are counties that are experiencing a shortage in maternity care resources. For example, there are no hospitals or birth centers or a lack of obstetric providers that are accessible within the area. As of 2025, more than 6.9 million patients and nearly 500,000 births each year are located within these deserts and as a result, are forced to travel long distances into urban cities in order to make appointments or deliver. The consequences of doing so place a burden onto the mother and child as research has found that distances to clinical care were associated with higher cesarean deliveries and preterm births. 

How is this related to the growing maternal mortality crisis?

Due to the shortages of OB/GYNs that already characterize maternity care deserts, the burden on the remaining providers increases. Within this context, childbearing services are becoming scarce as between 2006 and 2020, more than 400 birthing units were closed due to these staffing challenges which exacerbates the impact on rural areas that already had no maternity services to begin with. As such, the maternal mortality rate has steadily increased with black women experiencing a higher rate- almost triple- than that of white women. These racial disparities only worsen the already dismal state of maternal health despite the United States being one of the most resource-rich nations in the world. 

Historically, the US has been underfunded in areas of women’s health which can be seen in the staffing shortages due to the financial responsibility that is placed on facilities to cover the high costs of obstetric care. This high cost is due to the fact that maternity units must be open 24/7 and that most patients are covered by Medicaid, resulting in the closure of these units due to being unsustainable financially. Heartland Forward recently conducted a study regarding the economic implications associated with pregnancy outcomes and found that it created an indirect economic loss that cost the US economy $165.3 billion in 2020. It was also noted that a significant portion of these pregnancy outcomes were preventable and could have saved the US a whopping $78.6 billion. 

What is the impact of this for future OB/GYN doctors and midwives?

Although interest remains strong with OB/GYN resident programs attracting many strong applicants, the supply is not able to keep up. The number of available positions continues to lag behind despite the increasing need for obstetric care providers, which again is a consequence of the underfunding from the government. For example, the Health Resources and Services Administration predicted that by 2027, the US will only meet 82% of the demand for OB/GYNs. This mismatch between positions and demand creates a restrictive environment for patients as the limited staff lead to the making of difficult choices. Dr. Tiffany Simas, professor at the UMass Chan Medical School, stated that “earlier this year, we had to prioritize pregnant patients over gynecologic patients because of vaccines. We are rescheduling annual exams and referring some patients elsewhere.” 

Not only does the patient suffer however, but the OB/GYNs themselves. A survey sent out in 2025 by Medscape reported that over 25% of OB/GYNs were burned out and experiencing depression. As such, these feelings that have been generated from overnight calls and unpredictable hours frequently lead to many providers choosing to reduce their hours or leave the practice completely. 

What can be done to fix this crisis?
As of right now, efforts to expand training positions as well as implementing an OB Hospitalist Model would sustain these OB/GYN services among the shortages and closures. An OB Hospitalist Model ensures that a physician is dedicated only to inpatient obstetric care so that outpatient OB/GYNs can focus on clinical visits. This model has found that clinical outcomes with OB hospitalists significantly outperform national performance measures such as having a C-section delivery rate of 19.5% which is below the national goal of 23.6%. Other solutions such as increasing the number of locum tenens OB/GYNS- which are physicians and practitioners who temporarily fill in any staffing gaps to ensure continuous obstetric care for patients- are also viable options as well. Looking ahead, these efforts require the undivided attention and coordination of national and state action in order to recognize that maternity care is undergoing a serious public health crisis.

Copy editor: Ruth Stoia

Photography source: https://www.babylist.com/hello-baby/how-to-build-a-maternity-wardrobe