Insights
New report from March of Dimes* puts a hard number on something Maternal Fetal Medicine and Obstetric specialists have felt for years - the system is thinning out right where continuous monitoring matters most.
In the US, 1 in 3 counties remain maternity care deserts, home to 2.4 million women of reproductive age, with at least 96 labor and delivery unit closures reported across 35 states since January 2024. These deserts are defined as counties with no obstetric clinicians or birthing facilities at all, leaving women to travel farther simply to have their pregnancies monitored.
It adds to the US CDC's National Center for Health Statistics 2024 figure of 17.9 maternal deaths per 100,000 live births (published March 2026) - a rate substantially higher than that of most other high-income nations.
When distance becomes the risk to mothers & babies
Distance to specialist care shows up long before delivery day. Women living in maternity care deserts travel roughly three times farther, on average, to reach care than those in fully-served counties, and the consequences compound the earlier in pregnancy they start. Longer travel is associated with delayed entry into prenatal care in the first place - fewer early scans, fewer chances to catch a growth restriction or a developing complication before it becomes urgent. Distance is also tied to more unplanned out-of-hospital deliveries, higher rates of maternal morbidity, and more NICU admissions - outcomes that trace back to gaps in monitoring, not just gaps in delivery rooms.
And the burden isn't only clinical: every extra mile adds indirect costs for families too - transportation, childcare, missed work, temporary lodging - costs that make skipping a routine check-in tempting when the alternative is a half-day round trip.
The administrative strain behind the scenes
Every closed unit, every clinician shortage, doesn't just disappear - it gets rerouted. It lands on the MFM specialists and perinatal clinics still standing, who are now managing more complex, more geographically dispersed patients between visits, with less consistent monitoring data reaching them than the infrastructure around them was ever designed to support.
And that's the part that doesn't make headlines. As patients travel farther between appointments and monitoring gaps widen, the administrative backbone of a practice - scheduling, documentation, remote data intake, reporting across referring providers - has to work harder just to keep a fragmented care picture whole. Workflows that were merely inefficient in a lower-volume world become genuinely risky in one where visits are less frequent and each one has to count: slower billing cycles, more claim rejections, and a financial margin that erodes exactly when practices need it most to keep serving communities with no other option.
The specialists holding the line on maternal-fetal medicine are being asked to track more, for more dispersed patients, with less frequent in-person contact than the systems around them were built to assume.
Closing the gap with connected clinical workflow
Closing the care gap isn't only about clinician supply - it's also about making sure the monitoring and workflow infrastructure behind the clinic can keep a full picture of every pregnancy, even when the patient can't easily walk through the door.
*Source: March of Dimes, "Nowhere to Go: Maternity Care Deserts Across the U.S." Aug 11 2026