Why maternity care deserts happen
A 2025 analysis from the National Partnership for Women and Families found that 131 rural hospitals across the country with labor and delivery units were at risk of closure or severe service cutbacks because of H.R. 1.
Maternity care deserts happen because of a few factors. Ob-gyn services often lose money for hospitals because they have to be staffed with medical providers, including anesthesiologists, around the clock. In rural areas with low birth rates, hospitals have to spend the money to keep obstetric units staffed and open, even when there are relatively few births generating revenue. And because rural areas have high shares of patients on Medicaid, the hospitals also don’t receive adequate reimbursement.
“It’s sort of a double whammy,” Warren says. “Their birth volume is low, so they have fewer folks coming through to make those payments, but also, when they do get those payments, it’s likely to be lower because it’s more likely to be Medicaid.”
