New research out this week from nonprofit organization March of Dimes reveals that access to maternity care is declining in the US, where almost 6 million women are reportedly living with no or limited access to care. That's in part due to a 4% drop in availability of hospital birthing units in the past year as hospital administrators have been cutting unprofitable maternity services.
Maternal mortality
Data presented by the CDC in March only emphasizes the extent of the issue. In 2021, there were a total of 1,205 deaths in ~3.7 million live births, translating to a maternal mortality rate of 32.9 per 100,000 births — nearly double the rate seen as recently as 2018. And, while the US already had the worst maternal mortality rate among developed nations (in 2020, it was nearly 3x that of the next highest rate, France), the nation has seen the closure of more than 300 birthing units since 2018.
The figures are most pronounced in areas with limited access to care. Between 2018-2021, poorly connected Appalachian states saw the worst maternal mortality rates in the country, with Arkansas and Mississippi averaging more than 43 deaths per 100,000 births. Indeed, access to healthcare has diminished in the last decade, with more than 4% of rural hospitals closing between 2013-2020 and nearly half of all rural community hospitals providing no obstetrics care of any kind.
Divisions of labor
Maternity services dropping off across the country has only widened the disparity between certain populations. In 2021, the maternal mortality rate was 69.9 for Non-Hispanic Black women, more than 2.6x the rate for Non-Hispanic White women.
