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BMC Pregnancy and Childbirth

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Open Access 01-12-2024 | Research

Navigating geographical disparities: access to obstetric hospitals in maternity care deserts and across the United States

Authors: Jazmin Fontenot, Christina Brigance, Ripley Lucas, Ashley Stoneburner

Published in: BMC Pregnancy and Childbirth | Issue 1/2024

Abstract

Background

Access to maternity care in the U.S. remains inequitable, impacting over two million women in maternity care “deserts." Living in these areas, exacerbated by hospital closures and workforce shortages, heightens the risks of pregnancy-related complications, particularly in rural regions. This study investigates travel distances and time to obstetric hospitals, emphasizing disparities faced by those in maternity care deserts and rural areas, while also exploring variances across races and ethnicities.

Methods

The research adopted a retrospective secondary data analysis, utilizing the American Hospital Association and Centers for Medicaid and Medicare Provider of Services Files to classify obstetric hospitals. The study population included census tract estimates of birthing individuals sourced from the U.S. Census Bureau's 2017-2021 American Community Survey. Using ArcGIS Pro Network Analyst, drive time and distance calculations to the nearest obstetric hospital were conducted. Furthermore, Hot Spot Analysis was employed to identify areas displaying significant spatial clusters of high and low travel distances.

Results

The mean travel distance and time to the nearest obstetric facility was 8.3 miles and 14.1 minutes. The mean travel distance for maternity care deserts and rural counties was 28.1 and 17.3 miles, respectively. While birthing people living in rural maternity care deserts had the highest average travel distance overall (33.4 miles), those living in urban maternity care deserts also experienced inequities in travel distance (25.0 miles). States with hotspots indicating significantly higher travel distances included: Montana, North Dakota, South Dakota, and Nebraska. Census tracts where the predominant race is American Indian/Alaska Native (AIAN) had the highest travel distance and time compared to those of all other predominant races/ethnicities.

Conclusions

Our study revealed significant disparities in obstetric hospital access, especially affecting birthing individuals in maternity care deserts, rural counties, and communities predominantly composed of AIAN individuals, resulting in extended travel distances and times. To rectify these inequities, sustained investment in the obstetric workforce and implementation of innovative programs are imperative, specifically targeting improved access in maternity care deserts as a priority area within healthcare policy and practice.

Available only for authorised users

We recognize that using the term desert to describe counties is limited and can oversimplify the complex issues faced by communities most impacted by the maternity care crisis. For purposes of this paper “maternity care desert” is used to align with prior March of Dimes reports, we use the term desert to refer to a quality or ability to fail (someone), especially at a crucial moment when most needed, in the context of maternity care availability.

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Title: Navigating geographical disparities: access to obstetric hospitals in maternity care deserts and across the United States
Authors: Jazmin Fontenot
Christina Brigance
Ripley Lucas
Ashley Stoneburner
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: BMC Pregnancy and Childbirth / Issue 1/2024
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-024-06535-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Navigating geographical disparities: access to obstetric hospitals in maternity care deserts and across the United States

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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