New report shows access to maternal care worsens

By TAMMIE SLOUP
FarmWeek

In rural areas across Illinois, 35.5% of women live more than 30 minutes from a birthing hospital compared to 3.5% of women living in urban areas.

And in 21 counties, pregnant women must travel 28.4 miles or more to the closest birthing hospital.

The data comes from a new March of Dimes report that takes a deep dive into maternal care with a state-by-state analysis.

The Aug. 1 report, ”Where You Live Matters: Maternity Care Deserts and the Crisis of Access and Equity,” is a new collection of reports that shows more than 5.6 million women live in counties with no or limited access to maternity care services. The research shows that for millions of women in the United States, it’s more difficult to access maternity care. One of the largest analyses on maternity care access, the report offers insight into the factors that impact pregnancies in all 50 states, Washington, D.C., and Puerto Rico.

“A person’s ability to have a healthy pregnancy and healthy birth should not be dictated by where they live and their ability to access consistent, quality care but these reports show that, today, these factors make it dangerous to be pregnant and give birth for millions of women in the United States,” said Dr. Elizabeth Cherot, March of Dimes president and chief executive officer. “Our research shows maternity care is simply not a priority in our health care system and steps must be taken to ensure all moms receive the care they need and deserve to have healthy pregnancies and strong babies. We hope the knowledge provided in these reports will serve as a catalyst for action to tackle this growing crisis.”

Hospital closures and a shortage of providers are driving changes in maternity care access, especially within rural areas. Data shows that in Illinois, 34.3% of counties are defined as maternity care deserts.

Care deserts are defined as counties without obstetric providers or a hospital or birth center that offers obstetric care. Across the country, 6% of counties have less access to maternity care than they had in 2018, the first year March of Dimes issued a report on maternity care.

Mapping software calculated the average distance to the closest birthing hospital throughout Illinois to help identify areas where resources are needed to improve access to care. Overall in the U.S., women travel 9.7 miles to their nearest birthing hospital, with Illinois women traveling an average of 6.8 miles. However, women living in counties with the highest travel times could travel up to 47.8 miles and 59 minutes, on average, to reach their nearest birthing hospital, and 4.6% of women in Illinois had no birthing hospital within 30 minutes.

Of the 21 counties where women must travel 28.4 miles or more to the closest birthing hospital, Hardin County in southeast Illinois (the least populous county in the state) had the highest mileage reported at 47.8 miles.

The report also looked at availability of family planning services, disparities in prenatal care, chronic health conditions and preterm birth, and policy solutions and actions.

Other nationwide findings include:

The loss of obstetric units in hospitals was responsible for decreased maternity care access in 369 counties since the 2018 report, nearly one in 10 counties across the U.S.

Seventy additional counties have been classified as maternity care deserts due to a loss of obstetric providers and obstetric units in hospitals, since the initial report in 2018.

More than 32 million reproductive-age women are vulnerable to poor health outcomes due to a lack of access to reproductive health care services, like family planning clinics and skilled birth attendants.

States with the highest rates of maternity care deserts include Alaska, Nebraska, North Dakota, Oklahoma and South Dakota.

The report comes during a critical time for hospitals struggling with maternity unit closures, recruitment and staffing.

Even before the pandemic, hospitals started closing maternity units across the country because of low birth volume and rising costs. According to the American Hospital Association, more than 50% of births in maternity care deserts are reimbursed by Medicaid, which have lower reimbursement rates — forcing hospitals to make cuts that leave patients without access to care. In addition, the American College of Obstetricians and Gynecologists has reported obstetrics to have one of the highest burnout rates across medical specialties, making it difficult to recruit and retain providers.

Access the full report at marchofdimes.org.

This story was distributed through a cooperative project between Illinois Farm Bureau and the Illinois Press Association. For more food and farming news, visit FarmWeekNow.com.