A March of Dimes analysis finds one in six North Carolina counties lack birthing facilities or obstetric clinicians; state officials point to longer travel times, racial disparities in infant deaths, and federal funds used to expand regional services.
One in six NC counties are maternity care deserts, affecting about 61,000 women ages 18–44 and roughly 4,000 births a year.
Black infants die at three times the rate of white infants in NC despite the statewide infant mortality rate hitting a historic low in 2024.
State is using a $213 million federal rural health grant to create regional NC Roots hubs that connect medical, behavioral and social services and aim to expand prenatal access.
# What the report found A March of Dimes report presented to the N.C. Child Fatality Task Force shows widespread gaps in maternity care across North Carolina. One in six counties — with about 61,000 women of childbearing age living there — are classified as maternity care deserts, meaning they lack birthing facilities and obstetric clinicians. About 4,000 babies are born each year to mothers who live in those deserts.
# Where the gaps are concentrated Almost 67% of the maternity care deserts are in rural counties. Another group of counties, representing 12% of the state, have only one obstetric clinician. The distribution makes access uneven: some areas still have networks of providers, while other counties have virtually no local options for prenatal care or delivery.
# How access differs in practice On average, women in North Carolina travel 17 minutes to reach a hospital that offers labor and delivery. Women who live in maternity care deserts travel nearly twice that long, increasing the risk of delayed care in labor and making routine prenatal follow-up harder to keep. Longer travel times also complicate emergency transfers and postpartum checkups.
# Outcomes and racial disparities
# State response and resources North Carolina has received federal rural health transformation funds and is using the money to expand access to maternity care. The initial installment was $213 million. State health officials have set up regional "NC Roots" hubs intended to connect clinical care with behavioral and social services. Part of the hubs' assigned work is to develop plans to improve access to prenatal services, with an emphasis on the first trimester.
# Why the first trimester focus State public health leaders highlighted first-trimester access because early prenatal care affects screening, risk identification, and management of conditions that can influence birth outcomes. The hubs are expected to prioritize increasing early prenatal service availability in areas where access is weakest.
# What this means for families and policymakers Families in maternity care deserts face longer travel, fewer local clinicians, and greater obstacles to consistent prenatal and postpartum care. Policymakers have options that appear in the report and in state work plans: direct funding for local maternal services, regional coordination through hubs, and targeted efforts in counties with high infant mortality and socioeconomic stressors. The report frames the problem with current data but does not list specific legislative actions in this summary.
# Bottom line Carolina, quantifies the population affected, and situates those gaps within broader infant mortality and equity concerns. The state is deploying federal rural health funds into regional hubs meant to expand prenatal access, especially in early pregnancy, but disparities persist and travel burdens remain high for many women in rural counties.
In 14 states, the closure of the closest rural hospital or its obstetric unit would force many Medicaid patients to drive an hour or more to get to another hospital that provides inpatient maternity care, according to an analysis released this week. Nationwide, the median drive time between hospitals providing inpatien
In 14 states, the closure of the closest rural hospital or its obstetric unit would force many Medicaid patients to drive an hour or more to get to another hospital that provides inpatient maternity care, according to an analysis released this week. Nationwide, the median drive time between hospitals providing inpatien
A report on Kansas' struggle to deliver maternal healthcare seeks financial and policy reform to bring services to underserved urban and rural areas.
Melanie Pierce works with many pregnant women who know they’ll have a long drive ahead of them when labor starts. One of her jobs as a doula living in Mansfield, Missouri, is helping families answer a question that may not be as fraught for women who live closer to a delivery hospital: When is it […] The post Rural Mis
Randox Health The average person spends 20 years of their life in poor health. Let that sink in. But what if you could avoid that? While there are plenty of zeitgeisty ‘ solutions’ to better health floating around in the ether right now, many of them don’t come with a guarantee. It goes without saying that we’d go out
From readiness, longevity and AI insights to blood tests and movement assessments, we covered everything about the Health app’s redesign.
Loading more related stories...
Open the app view to save this story, compare related coverage, and continue from the same source.