March of Dimes: Over One-Third of U.S. Counties Remain Maternity Care Deserts
More than one in three U.S. counties still has no local place to give birth and no obstetric clinician. Families in those counties drive farther, start prenatal care later, and face higher complication rates. Midwives working with hospital teams are one of the few workforce tools that can put routine pregnancy care back closer to home. The March of Dimes 2026 report finds 34.6 percent of counties are maternity care deserts after at least 96 labor-unit closures since January 2024. More than 2.4 million women of reproductive age live in those counties.
Based on reporting from Contemporary OB/GYN: March of Dimes: 1 in 3 US counties remain maternity care deserts.
If the nearest birth hospital is an hour away, start here
Planning a birth around highway traffic is not a lifestyle preference. It is a safety problem. People delay prenatal visits when each appointment costs a half day of work and a long drive. Some deliver on the way.
You did not cause the closure of a labor unit. Hospital finances, staffing, and liability costs did. Your job is to map a real hospital and a real ride before labor starts.
The March of Dimes report titled 'Nowhere to Go: Maternity Care Deserts Across the U.S.' puts national numbers on that map. The short version: 34.6 percent of counties have no local obstetric care, and at least 96 units have closed since January 2024.
What the 2026 report counted
Approximately 34.6 percent of U.S. counties remain maternity care deserts: zero hospitals offering obstetric services, zero accredited birth centers, and zero practicing obstetric clinicians. That deficit affects more than 2.4 million women of reproductive age.
Nationwide, financial pressure, staffing shortages, and liability costs have driven at least 96 labor and delivery closures since January 2024. Patients in deserts travel an average of 34 miles for hospital birth, compared with 9.7 miles in counties with full obstetric access.
Longer travel is associated with a 22 percent increase in severe maternal morbidity (life-threatening complications around birth) and an 18 percent higher rate of neonatal intensive care admission. Geography also tracks with missed prenatal visits, unmanaged gestational conditions, and more emergency out-of-hospital births.
In Arizona: metro hubs and long desert drives
Urban Maricopa County has high-volume perinatal hospitals. Adjacent rural and suburban communities do not. Regional shifts, including rural unit closures in Pinal County and northern Arizona, have concentrated deliveries in metropolitan hubs.
Patients in Casa Grande, Maricopa, Apache Junction, and outlying desert areas often face 45- to 75-minute commutes on congested interstates to Banner Desert Medical Center, Chandler Regional, or Mercy Gilbert. For someone with a history of rapid labor or with preeclampsia (pregnancy-related high blood pressure), that commute is a clinical vulnerability, not a convenience issue.
The Science Behind ItWhy midwifery is a desert strategy
The American College of Obstetricians and Gynecologists (ACOG) and the American College of Nurse-Midwives (ACNM) identify Certified Nurse-Midwives as central to shrinking deserts. In states with full practice authority, including Arizona, CNMs can run outpatient antenatal clinics and coordinate hospital delivery through regional networks.
The model is a split, not a replacement. Midwives handle uncomplicated prenatal care, routine screenings, and low-intervention hospital birth. Collaborative agreements keep physician backup for surgery or high-acuity care. Patients can complete about 90 percent of visits locally and travel for delivery only.
States with high midwifery integration show lower primary cesarean rates, lower preterm birth rates, and higher patient satisfaction. That is workforce design, not a wellness slogan.
Clinical Insight for ProvidersHybrid schedules beat empty units
You cannot reopen 96 closed labor floors from a blog post. You can staff neighborhood prenatal clinics and keep the regional hospital for birth. Routine blood pressure, fetal Doppler checks, and physical exams belong with CNMs and nurse practitioners close to home. High-risk consults for preexisting diabetes or multiples can move to secure telehealth with maternal-fetal medicine.
Document travel time in the problem list. A 70-minute interstate drive changes induction timing, preeclampsia counseling, and when you tell a patient to leave home in labor.
Closures cluster where Medicaid reimbursement is low, night call is unpaid, and birth volume cannot fund a 24/7 surgical suite. Midwifery integration is one of the few interventions that expands coverage without requiring a new hospital tower.
If your community hospital closed its maternity unit
You can still see a midwife locally. Many practices keep outpatient clinics in communities without labor units. You receive prenatal and postpartum care close to home and travel to an affiliated regional hospital for labor.
Ask three operational questions: which hospital holds the midwife's privileges, whether that hospital is in-network, and how the team handles a fast labor or a blood-pressure emergency on the drive.
Questions this headline raises
A maternity care desert is a U.S. county with no hospitals offering obstetric services, no accredited freestanding birth centers, and no licensed obstetric providers (OB/GYNs or Certified Nurse-Midwives).