In 4 Triad counties, there's nowhere for new moms to go for maternity care—and they're not the only ones in NC

GREENSBORO, N.C. (WGHP) – Four counties in the Piedmont Triad are designated as “maternity care deserts,” and two others are considered to have low levels of available care for mothers and babies.

Alleghany, Caswell, Montgomery and Stokes are among the 18% of the counties in North Carolina that are defined as maternity care deserts, or counties in which there were no hospitals providing obstetric care, no birth centers, no OB/GYN specialists and no certified nurse midwives.

Census audit shows North Carolina stable while other counts swing

Two other counties in the Triad, Davidson and Randolph, were rated as low for maternity care. That means they have fewer than two hospitals and birth centers offering OB care, fewer than 60 OB/GYN providers or certified nurse midwives per 10,000 births and 10% or less of women 18-64 without health insurance.

Maternity care deserts across the U.S. There are 18 counties in North Carolina. (MARCH OF DIMES)

March of Dimes, using data from 2020, found that, based on counts from the 2010 census, there were nearly 3 million women nationwide between the ages of 15 and 44 – the most common child-bearing years – who had low access to maternity care. The report found that there were 1,095 counties nationally that rate as maternity care deserts, and 359 more rated in the Low category.

More than 53,000 females reside in the four counties in the Triad designated as maternity care deserts, based on a Census Bureau report from 2021. About 80% of them typically are older than 19, and a significant percentage is between the ages of 15 and 44. In Randolph and Davidson counties, there are more than 161,000 females.

Based on the most recent data available, as compiled by the NC Department of Public Health for the County Health Data Book, the four counties designated as maternity care deserts accounted for more than 900 live births in 2020. All but two of those were between the ages of 15 and 44. Two births were to 14-year-olds.

This is how the density of maternity care deserts plays out by state. (AXIOS)

Davidson and Randolph counties accounted for 3,258 live births in 2020, all but six of those in the 15-44 range. The rest were all older. By comparison the Census Bureau reports there were 114,011 births statewide in the year ending June 30, 2021.

Insufficient numbers

Birth rates nationally have been declining, but some health care experts are suggesting that this problem OB/GYN care could be exacerbated in states that tighten abortion restrictions or ban abortions entirely. Birth rates are expected to climb as fewer terminate pregnancies.

The American Congress of Obstetricians and Gynecologists reported in 2019 that there was a shortage of about 9,000  OB/GYN specialists nationwide, and that number was expected to grow to 22,000 by 2056.

“The ramifications of this shortage for women’s health extend far beyond childbirth,” that report stated. “While OB-GYNs are a primary source of care to women during pregnancy and delivery, they also provide a wide range of gynecologist care throughout women’s lives.”

Further, the U.S. Bureau of Labor and Statistics reported that in 2018 there were 480 employees of OBGYNs in North Carolina.  The state’s population is now more than 10 million. Job postings show dozens of open positions for OB/GYN employees across the state.

Interactive Map: How much is the living wage in each Piedmont Triad county?

More problems ahead?

If the Supreme Court overturns Roe v. Wade, as a leaked draft opinion suggests it will, the expansion of births is expected to put more pressure on counties in which there already is no care.

There is a likelihood that states poised to have automatic abortion bans are among those likely to have a high percentage of maternity care deserts, Axios reported. The highest percentage of maternity care deserts are in the Dakotas, Nebraska, Mississippi, Kentucky, Arkansas and Texas.

North Carolina has one of the lower percentages of counties that have maternity care deserts. Most of the lowest are in the northeast, where the population tends to be more concentrated. Several states had no counties with maternity care deserts.

But of the roughly 18 counties in North Carolina that qualify, most are in the extreme east and western areas. None of the most populous counties has any problems with service.

North Carolina in 2020 had a total pregnancy rate of 68.6, and the fertility rate was 56.2. The abortion rate was 12.1, the highest in 10 years, the North Carolina Division of Public Health reported.