A new March of Dimes report finds that 34.6% of U.S. counties lack adequate maternity care access, affecting 2.4 million women of reproductive age and about 149,000 births each year, with rural communities facing some of the largest gaps.
By yourNEWS Media Newsroom
More than one-third of U.S. counties are classified as maternity care deserts, leaving millions of women with limited access to obstetric services and forcing many to travel considerably farther for labor and delivery care, according to a March of Dimes report released Tuesday.
(2026 March of Dimes report): Maternity care access designations by county, U.S. and Puerto Rico
The report found that 34.6% of counties nationwide fall into the maternity care desert category. Those communities are home to approximately 2.4 million women of reproductive age and account for about 149,000 births annually.
MCDR 2026 Report English by yourNEWS Media
Women living in maternity care deserts, many of which are in rural areas, travel roughly three times farther on average to obtain labor and delivery services than women living in counties with greater access to maternity care.
Another 3.4 million women and 209,000 infants live in counties rated as having low or moderate maternity care access, according to the report.
More than half of all U.S. counties have no hospital providing labor and delivery services, a shortage affecting nearly 370,000 births each 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 shortage is especially pronounced in rural America.
Nearly 58% of rural counties have no obstetric clinicians, compared with approximately 19% of urban counties, the March of Dimes found.
The organization also identified an estimated 96 publicly reported labor and delivery unit closures across 35 states between January 2024 and May 2026.
“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.”
Insurance coverage represents another challenge. March of Dimes estimates that about 1 in 9 women of reproductive age nationwide are uninsured, with the highest concentrations found in the South, rural communities and maternity care deserts.
The findings come as many rural hospitals have stopped providing childbirth services amid financial and staffing pressures.
Since the end of 2019, 139 rural hospitals have either stopped delivering babies or are expected to discontinue those services by the end of 2026, representing a 13% decline in rural labor and delivery units, according to estimates from Becker’s Payer Issues.
Women in rural communities can also encounter obstacles involving maternity care, reproductive health services, postpartum support and access to paid leave, according to the Rural Health Information Hub.
Limited access to maternal health services in rural areas has been associated with premature birth, low birth weight, maternal and infant morbidity and mortality and an increased risk of postpartum depression, according to a September 2022 article published through the National Library of Medicine.
The availability problem is compounded by the financial burden associated with pregnancy and childbirth.
Maternity care expenses have increased in recent years, creating additional financial challenges for women and families.
A KFF analysis released in September 2025 found that pregnancy, childbirth and postpartum medical expenses averaged $20,416 for women covered by employer-sponsored health plans.
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