The 1,100 Counties Without an OB-GYN — What It Means for Families and Maternal Health

“1,100 counties in the US have no obstetric clinician or birthing facility” isn’t just a statistic — it represents a barrier to how, where, and whether a person can give birth safely. It also reflects how (un)important it is to the US medical system that women and families have access to quality maternal care. 

Over 35% of U.S. Counties Have No Obstetric Care

• The March of Dimes defines a maternity care desert as a county with no hospitals or birth centers offering obstetric services and no OB-GYNs or other obstetric providers.

• In that same report, those 1,104 “desert” counties represent over one-third of all counties.

• These deserts are home to over 2.3 million women of childbearing age. March of Dimes

This lack of proximity doesn’t just create inconvenience — it creates danger. Families face increased risks of preterm birth, complications from delayed care, and maternal mortality. Hospital systems follow profit margins, not population needs.

The U.S. Maternal Mortality Rate Remains Shockingly High

• In 2022, the U.S. recorded 22.3 maternal deaths per 100,000 live births. 

• This rate is significantly higher than peer high-income countries. 

• Black mothers in the U.S. are disproportionately impacted — with rates nearly 2.5 times higher than White mothers. The Guardian

This isn’t just a failure of medicine — it’s a failure of systems. Women face fragmented prenatal care, short postpartum follow-ups, and overwhelming medical costs. Many providers work under time and insurance constraints that make personalized care impossible. Families are left navigating pregnancy in an impersonal and inaccessible medical system that treats birth as a liability instead of the beginning of a new life.

Hospitals Are Closing Obstetric Services, Especially in Rural Areas

• Over half of rural counties do not have a hospital with obstetric services as of recent studies.

• Between 2010 and 2022, rural hospitals cut or closed obstetric units, especially in states with high rural populations (e.g., Oklahoma, West Virginia, Mississippi).

• In 2022, nearly 59% rural counties lacked any hospital-based obstetric service. American Hospital Association

While institutional maternity care has contracted, community birth workers — doulas, certified midwives, IBCLCs, pelvic floor therapists, and perinatal educators — have grown. The American Midwifery Certification Board reports a 33% increase in certified midwives over the past decade, and doulas are now attending hospital births, home births, and everything in between.

Families are turning to these professionals not just for advocacy, but for personalized care, compassion, and empathy— things that hospitals can’t provide. These care providers represent rebalance maternal health on trust, prevention, and partnership, rather than procedures and billing codes.

What Root Brings to the Table

While Root is not a substitute for emergency obstetric care, here’s how it can make a difference:

• Connect families in maternity care deserts with providers willing to travel or offer teleconsults

• Enable midwives and doulas to find new clients beyond their immediate geography

• Support continuity of care and advocacy through messaging and provider relationships

• Help families discover holistic options when hospital-based care is far away or inaccessible

Sources:

• March of Dimes. Nowhere to Go: Maternity Care Deserts Across the U.S. (2022)

• CDC National Center for Health Statistics (2023). Maternal Mortality in the United States.

• American Midwifery Certification Board (2023). Annual Report.

• Health Resources and Services Administration (HRSA). Rural Health Data Dashboard.