Living in a state like Colorado, particularly in major cities such as Denver or Aurora, you may not have to go far to reach a small or large hospital. According to a journal cited, about “36% of all US counties qualify as maternal care deserts”, emphasizing a significant disparity for those in rural areas. (Adashi, O’Mahony, & Cohen, 2025) An obstetric desert is defined as a county where there are “no hospitals offering obstetric services or birth centers and no obstetricians, gynecologists or certified nurse midwives”. (Adashi, O’Mahony, & Cohen, 2025) Access to quality prenatal and postpartum care should be accessible for all, but it is not.
Why should we care?
Black women are impacted the most by this deficit and marginally experience maternal mortality at 2.6 times that of white women. In an attempt to fill this gap, birth centers have taken a rise. I have recently been listening to a podcast titled ‘Something Was Wrong’. In a recent season, they interviewed women in Texas who were impacted by obstetric deserts and, with a desire to take their pregnancy and birth journey into their own hands, turned to birthing centers. Some recounted positive experiences, while others noted the trauma and unfortunate medical negligence that impacted their birthing experience. I bring up this podcast to mention one woman’s experience, which led to fetal mortality. This was due to poor care from an uncertified midwife. Birth centers may be a growing solution, but they also operate in an unregulated space. We need quality care for women across the board. Are birth centers the solution? If so, how do we ensure mom and baby are well cared for from start to finish?
Having witnessed a handful of births, I recognize that it is a profoundly trying and vulnerable time for a mother, and I believe she should be spoiled for choice when it comes to her care. Our healthcare system is broken, and structural racism and inequities impacting a mother’s ability to bring life and joy into this world are unacceptable.
Adashi, E. Y., O'Mahony, D. P., & Cohen, I. G. (2025). Maternity Care Deserts: Key Drivers of the National Maternal Health Crisis. Journal of the American Board of Family Medicine : JABFM, 38(1), 165–167. https://doi.org/10.3122/jabfm.2024.240198R1
You raise a strong point that birth centers can help fill gaps, but without proper regulation they may lead to unsafe outcomes. I also appreciate how you connected this issue to the disproportionate impact on black women, showing that access is shaped by both geography and systemic inequities. It makes me wonder what steps could be taken to expand access while still guaranteeing safe and consistent standards of care.
ReplyDeleteI agree that accessible birth cares may help but there may be some mishaps along the way. I sought a reviewed paper on birth centers and there were well-constructing findings. Vaginal birth (spontaneous) and perineal integrity were higher at birth centers compared to the hospitals as well as, cesarean births were lower at the birth centers. ( Alliman & Phillippi, 2016). I wonder if these birth centers have equipment provided in case of emergencies and how they train their midwives for these events. It is a necessity for mothers to obtain adequate care especially during a vulnerable time.
ReplyDeleteAlliman, J., & Phillippi, J. C. (2016). Maternal Outcomes in Birth Centers: An Integrative Review of the Literature. Journal of midwifery & women's health, 61(1), 21–51. https://doi.org/10.1111/jmwh.12356