Our opinion: Maternal care lacking in state

There’s a desert on our doorstep.

Of course, it’s not the desert where you would find lots of sand, snakes or cacti. What we’re talking about is a “maternal care desert,” where women of childbearing age do not have nearby access to obstetric care, birth centers, certified midwives or OB/GYNs. According to a report released in October by the March of Dimes, Juniata County is one of six counties in Pennsylvania that is now classified as a maternal care desert, along with Cameron, Forest, Greene, Sullivan and Wyoming counties.

All told, across Pennsylvania, 105,000 women between the ages of 18 and 44 live in communities that have a paucity of obstetric care or none at all. Across the United States, that number reaches 6.9 million, with the largest concentration of maternal care deserts in the center of country, stretching from the Dakotas to Texas. According to the March of Dimes report, there’s been a 2% increase in locations classified as maternal care deserts since 2020.

This is part of the reason the United States has the highest maternal mortality rate among industrialized nations.

Dr. Zsakeba Henderson, senior vice president and interim chief medical and health officer for the March of Dimes, told NPR, “Many people don’t know that we are in a maternal and infant health crisis in our country. Our country is currently the least safe to give birth and be born in among industrialized countries, and … part of that problem is not having access to high-quality maternity care. We have failed moms and babies too long in our country, and we need to act now to improve this crisis.”

Part of the reason maternal care deserts have emerged is down to dollars and cents. Rural hospitals have closed as populations have declined, and some of the hospitals that have kept their doors open have dropped maternity care because it isn’t cost-effective due to low patient volumes. Some communities have also struggled to draw qualified medical personnel.

Some experts have suggested that telehealth can help fill the gaps, but some of the communities lacking maternal care also don’t have adequate broadband. They also say that Medicaid needs to be expanded and more midwives and doulas need to be available in communities off the beaten track.

The gridlock in Washington, D.C., makes it unlikely any meaningful changes in federal policy are in the offing that would help remedy this problem. In the absence of federal action, state and local officials should do what they can to make giving birth safer and healthier in their communities.


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