A new national report shows a third of the country now qualifies as a full-blown medical gap, and Black families are the ones experiencing the worst of it. Maternity care deserts have spread across a third of the United States, and the newest national data shows Black mothers are paying the steepest price for it. According to March of Dimes, 5.8 million women currently live in counties without full access to pregnancy and delivery care, and the gap keeps growing every year the report is released.
The nonprofit’s 2026 study, titled “Nowhere to Go,” found that 34.6 percent of U.S. counties are officially classified as maternity care deserts, meaning they have zero birthing facilities and zero obstetric clinicians. That designation alone covers 2.4 million women of reproductive age and roughly 149,000 babies born each year in places where the closest delivery room can be an hour or more away. Per the report, this crisis didn’t happen by accident. It describes the pattern as “the result of policy decisions and longstanding underinvestment in maternity care infrastructure.”
The damage isn’t limited to counties with zero access. Per a March of Dimes news release, at least 96 labor and delivery units closed across 35 states between January 2024 and May 2026, and nearly 60 percent of those closures wiped out the only birthing facility a county had left. More than half of all U.S. counties now lack a hospital offering labor and delivery services at all, a gap that touches close to 370,000 births every single year.
The rural-urban split is stark. According to the report, almost 58 percent of rural counties have no obstetric clinician whatsoever, compared with roughly 19 percent of urban counties. Women stuck inside maternity care deserts travel about three times farther on average to reach a delivery room than women in counties with full access, and that extra distance is directly linked to delayed prenatal visits, more unplanned births outside a hospital, and higher rates of complications for both mother and baby.
This is where the numbers turn especially heavy for Black families. According to CDC data cited by March of Dimes, the maternal mortality rate for Black mothers reached 44.8 deaths per 100,000 live births in 2024, more than three times the rate of 14.2 for white mothers. Advocates have argued for years that Black mothers are treated as an afterthought inside a system already stretched thin by maternity care deserts, and the latest numbers make that argument hard to ignore.
Advocates worry that inconsistent abortion access combined with anti-DEI policy shifts under Trump could widen the disparity even further in the years ahead. Angela D. Aina, who co-founded and leads the Black Mamas Matter Alliance, continues to point to the organization’s Black Maternal Health Week every April as one of the few consistent pushes keeping the issue in front of lawmakers and the public.
The human cost of maternity care deserts shows up clearest on the ground. According to NPR, Alabama midwife Nadia Gramby spends her days and nights crossing maternity deserts to reach Black mothers who would otherwise have nowhere close to deliver safely. Dr. Michael Warren, chief medical and health officer for March of Dimes, told the outlet the situation “goes beyond a mere inconvenience,” since women stranded in these counties face a real jump in bad pregnancy outcomes once labor starts.
There are fixes already showing traction, according to the report. Sixteen states have expanded what midwives can legally do, including independent practice, prescribing authority, hospital admitting privileges, and pay equal to what physicians receive for comparable care. Twenty-six states plus Washington, D.C. now allow doulas to enroll as Medicaid providers and bill the program directly, giving more families a paid support system through pregnancy and delivery instead of navigating it alone.
None of this closes the gap on its own. Maternity care deserts will keep expanding, and Black mothers will keep absorbing the worst of the fallout, unless states move fast on workforce pipelines, insurance coverage, and the hospital funding that keeps labor and delivery units open in the first place.
