Maternity Deserts in the United States and the Threat to Women's Health

Author: Danielle Castano, MA March 4, 2025

Introduction

The United States is facing a shortage of maternity healthcare providers. Currently, 35 percent of counties around the United States do not have any access to obstetric care, which has led to the presence of maternity deserts (Edwards, 2024). March of Dimes defines a maternity desert as an area lacking in obstetric care. In 2022, the verdict of Roe v. Wade, a Supreme Court ruling that legalized abortion in the United States in 1973, was overturned, leaving the status of abortion rights up to individual states. As a result, several states criminalized abortion unless the mother’s life was in danger, and the number of maternity deserts increased. For example, in states such as Texas, doctors can be imprisoned and fined for performing an abortion. Because of the restrictive abortion policies, obstetric healthcare providers are moving their practices to states with less stringent policies. This article will explore how the overturning of Roe v. Wade has exacerbated the rates of maternity care deserts in the United States.

[Image source: “Interactive Map: US Abortion Policies and Access After Roe”, The Guttmacher Institute] Above is a map of abortion policies in the United States. In this map, ‘protective’ refers to the protection of abortion. For more information, the Guttmacher Institute has an interactive map with more details on states’ abortion policies.

Background

Since the overturning of Roe v. Wade, several states have enacted restrictive abortion policies in addition to legislation punishing doctors for performing such procedures. Women who require abortions for miscarriages are no longer receiving them, leading to severe injuries or death. For example, several women have died in Texas due to not being able to receive an abortion during a miscarriage. Doctors in states with restricted access to maternity care are concerned about facing legal action as a repercussion of performing an abortion. Currently, the only state in the Southeast where people can obtain this medical care after six weeks of gestation is North Carolina (Hensley and Washington, 2025). The increase in maternity deserts is not solely due to the abortion policies enacted; hospital obstetrics wards were closing due to the lack of funding before the overruling of Roe v. Wade (Edwards, 2024). However, these abortion bans have exacerbated the absence of available maternity health care.

Due to such strict legislation, doctors are electing to practice medicine in states with less restrictive abortion bans. Declercq et al. (2022) found that states with partial or complete abortion bans have fewer maternity care providers, higher rates of maternal mortality and infant death, more maternity deserts, and higher death rates for women of reproductive age. Over 1.7 million women of reproductive age (roughly three percent) live in a county in the United States without access to abortion and maternity care services (Rader et al., 2023). ProPublica (2024) found that in a few states, political leaders who backed abortion bans have dismissed maternal mortality review committees or slowed down their work.

[Image source: “Nowhere to Go: Maternity Care Deserts Across the US”, March of Dimes] The map above shows access to maternity care in the US. For more information, March of Dimes has an interactive map with the status of all counties listed.

In 2023, the Center for Reproductive Rights and several women who were denied abortion care in Texas filed a lawsuit against the state seeking to clarify its medical emergency exemption which contains an exception for the life and health of the pregnant woman. The unclear language surrounding the exemption and criminal prosecution for performing an abortion has deterred doctors from providing abortion care. The complainants who filed the lawsuit experienced severe pregnancy complications, with some having to leave the state to receive an abortion or deliver stillborns (Center for Reproductive Rights, 2025). In 2024, the Texas Supreme Court denied the request to clarify the state’s medical emergency exemption, leaving physicians confused and concerned about legal persecution in rare instances where they were permitted to perform an abortion. Since 2024, there have been 40 cases filed challenging abortion bans in 23 states, 22 of which are pending at trial or appellate levels (German et al., 2024). 

Conclusion Since the overturning of Roe v. Wade, several states in the United States have passed legislation restricting or banning abortion. States with these restrictive measures are more likely to lack obstetric providers and experience higher rates of maternal mortality and infant death. As states continue to pass laws limiting the right to abortion, more maternity deserts will appear, putting women’s health at risk. In communities that penalize doctors who perform abortions, the consequences are even greater; doctors fear legal repercussions and establish a practice elsewhere as a result. Funding for maternity care in many counties in the United States is already lacking, and abortion bans are further worsening the issue.

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Glossary

• Appellate- Involving an attempt to get a legal decision changed.

• Center for Reproductive Rights- Works to protect and advance abortion rights around the world by removing restrictive laws and policies, promoting measures to improve access to safe and legal abortion, and countering efforts to undermine access to abortion care.

• Enacted- to put something into action, especially to make something law.

• Exacerbate- to make something that is already bad even worse.

• Gestation- Gestation is defined as the time between conception and birth.

• Legislation- The preparing and enacting of laws by local, state, or national legislatures

• Maternity- A hospital facility designed for the care of women before and during childbirth and for the care of newborn babies

• Maternal mortality- The annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy.

• Maternity deserts- Maternity deserts are counties across the U.S. where access to maternity care services is limited or absent, either through lack of services or barriers to a woman's ability to access that care within counties.

• Obstetric- A branch of medicine that specializes in the care of women during pregnancy and childbirth and diagnosing and treating diseases of the female reproductive organs.

• Overruling- (of a person with official authority) to decide against a decision that has already been made.

• Overturned- To change a legal decision.

• Policies- A set of ideas or a plan of what to do in particular situations that has been agreed to officially by a group of people, a business organization, a government, or a political party.

• Repercussions- The effect an action, event, or decision has on something, especially a bad effect.

• Reproductive age- The CDC considers the age range of 15 to 44 to be the reproductive age.

• Roe v. Wade- The U.S. Supreme Court decided that the right to privacy implied in the 14th Amendment protected abortion as a fundamental right.

• Solely- Only and not involving anyone or anything else.

• Stillborn- A stillbirth is when a fetus dies in the uterus after 20 weeks of pregnancy.

• Stringent- Having a very severe effect, or being extremely limiting.

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Sources

1. Center for Reproductive Rights. (2025). Texas medical exceptions case. Retrieved from https://reproductiverights.org/case/zurawski-v-texas-abortion-emergency-exceptions/

2. Declercq, E., Barnard-Mayers, R., Zephyrin, L. C., & Johnson, K. (2022). Retrieved from https://www.commonwealthfund.org/publications/issue-briefs/2022/dec/us-maternal-health-divide-limited-services-worse-outcomes

3. Edwards, E. (2024). Pregnant women can’t find doctors in growing maternity care deserts. Retrieved from https://www.nbcnews.com/health/health-news/pregnant-women-cant-find-doctors-growing-maternity-care-deserts-rcna169609

4. German, M., Nidiry, R., Seid, B., Waldman, M., Bannon, A., & Goitein, E. (2024). State Court Abortion Litigation Tracker. Retrieved from https://www.brennancenter.org/our-work/research-reports/state-court-abortion-litigation-tracker

5. Hensley, E., & Washington, J. (2025). How major abortion laws compare State by state: Map. Retrieved from https://fullerproject.org/story/how-major-abortion-laws-compare-state-by-state-map/

6. Surana, K., Elba, M., Jaramillo, C., Fields, R., & Branstetter, Z. (2024). Are abortion bans causing deaths? states that passed them are doing little to find out. Retrieved from https://www.propublica.org/article/abortion-bans-deaths-state-maternal-mortality-committees#:~:text=In%20states%20with%20abortion%20bans,conception%E2%80%9D%20still%20in%20their%20bodies.

7. Rader, B., Brownstein, J., & Westman, N. (2023). Maternal care deserts overlap with lack of abortion access, analysis shows. Retrieved from https://abcnews.go.com/Health/abortion-access-restrictions-affect-maternity-care-access-research/story?id=101770115

8. Rader, B., Brownstein, J., & Westman, N. (2023). Maternal care deserts overlap with lack of abortion access, analysis shows. Retrieved from https://abcnews.go.com/Health/abortion-access-restrictions-affect-maternity-care-access-research/story?id=101770115