North Carolina maternal care deserts by the numbers

FILE PHOTO

More than 2 million women live in maternity health deserts, where they have little or no access to a hospital or health provider. Twenty-one of North Carolina's 100 counties are considered maternity health deserts, according to a study by the March of Dimes.

As maternal death rates rise across the United States, there is a push for reform in maternal care.

More than 2 million women live in maternity care deserts, or areas where there is little to no access to a hospital or a health provider. In North Carolina, 21 of the state’s 100 counties are defined as maternity care deserts, compared to 36% in the U.S, according to a report by the nonprofit March of Dimes, which advocates for healthy babies.

For instance, Alleghany, Anson, Bertie, Graham, Pamlico, Polk, Montgomery, Mitchell, Washington, and Stokes were some of the counties listed as maternity care deserts.
Some of the counties identified as having low access to maternity care include Davidson, Halifax, Brunswick, Pender, Rowan, Warren, Wayne, Sampson, and Wilson.  

“In North Carolina, we have 40 counties that meet the criteria of low access or no access to care,” said Michaela Penix, director of maternal and infant health in North Carolina. “In our latest iteration of the report, we know that in some counties, folks have to drive almost an hour to the place where they’re going to give birth.”

In North Carolina, the average woman lives about 11 miles from a hospital or birthing facility.

Between 2019 and 2020, there was about a 2% decrease in the number of birthing hospitals in the state. Although the number sounds small, many pregnant women lost access to care with several hospitals closing before and during the pandemic.  

The report, Where You Live Matters: Maternity Care Deserts and the Crisis of Access and Equity, found that 13% of women in the state did not have access to a birthing facility within 30 minutes of where they lived compared to 9% in the U.S.

Women who have preexisting health conditions like diabetes and high blood pressure before conception have an increased likelihood of having a baby born prematurely compared to women with no health issues.

Although there are underserved Black neighborhoods in Charlotte that lack access to a nearby hospital, the city does not qualify as a maternity care desert, according to Penix.
“Charlotte doesn't meet the criteria, Mecklenburg County doesn’t meet the criteria as a maternity care desert,” she said. “However, we do know that there are specific issues in and around the Charlotte-Mecklenburg area as it relates to maternal health and birth outcomes, and which is why March of Dimes has taken the steps to make investments in that community.”

The North Carolina chapter of March of Dimes has partnered with Novant Health and Blue Cross Blue Shield of North Carolina to establish group prenatal care in Mecklenburg County. They also have partnered with the Delta Zeta Chapter of Zeta Phi Beta Sorority in Charlotte on the Stork’s Nest, a prenatal education program to prevent the causes of low birthweight, premature births, and infant deaths.

If there were hospitals built in neighborhoods such as Beatties Ford Road or on Wilkinson Boulevard as opposed to health clinics, it would make it easier for expectant mothers to access a birthing facility without having to travel a long distance.

Novant Health hospital has made a long-term commitment to improve maternal health and reduce health disparities that occur, especially among women of color.

“Novant recognizes that there is a need in the community that we understand,” said Dr. Kara Stratton. “In the United States, moms and babies are at particularly high risk.”

A program that rolled out in 2021 is a maternal food security program to address the issue of food insecurity. When mothers come to the clinic, those who admit to being food insecure are connected with a social worker and directed to Loaves & Fishes.

“I think we had about 330 participants,” said Stratton. “Of those people, 82% of them actually went out and used the program.”  

Health experts are also placing more emphasis on women seeking preconception counseling to plan for a future pregnancy. In preconception counseling, a provider discusses a patient's family history, risk factors, medical conditions, and lifestyle prior to pregnancy to lower the chances of health complications.

“Our folks need access to care before, during and after pregnancy and I emphasize the before part in this particular space, because that's where we can kind of address and maintain chronic conditions prior to pregnancy,” said Penix.

North Carolina is set to expanded Medicaid eligibility under a bill passed by lawmakers and signed by Gov. Roy Cooper pending the passage of a state budget. Expansion is expected to give an estimated 500,000 low-income people access to health care, including more women access pre- and postnatal services.  

Aaliyah Bowden, who covers health at The Post, is a Report For America corps member.

Comments