The Deadly Combination of Pregnancy and Rural Living in the United States | Nonprofit Quarterly | Civic News. Empowering Nonprofits. Advancing Justice.

"After more than a week of struggling to access maternal care-long drives to a distant clinic, confusing insurance forms, and even longer drives to the hospital-she miscarried the pregnancy she had longed for. Aisha, who is using only her first name for safety reasons, made the long drive home alone. Many other rural women in Texas never return home at all."

"All across the United States, pregnancy and rural living has proved to be a deadly combination. Pregnant people in rural areas are twice as likely to have complications than their urban counterparts. These people, like Aisha, have to travel up to 100 miles to access care due to a lack of availability. And this lack of healthcare access kills. Lack of Access Maternal care deserts are an issue of infrastructure."

"For pregnant people like Aisha who are poor, live in rural areas, and speak limited English, the odds are stacked against them. And the risks are about to get worse: Looming Medicaid cuts threaten rural hospitals specifically, as 47 percent of births in rural areas are covered by Medicaid. That could mean even more preventable deaths in places like Texas, where an outsized rural population must contend with vast maternal care deserts, restrictive abortion laws, and, as a consequence, the country's highest number of childbirth-related deaths over the five years between 2018 and 2022."

Pregnant people in rural areas face severe barriers to maternal care, including long drives, confusing insurance processes, and scarce local providers. Medicaid covers nearly half of rural births, and proposed Medicaid cuts threaten financial stability of rural hospitals. Rural hospitals are fewer, more likely to close, and often lack obstetricians, maternity wards, birth centers, and midwives. Restrictive abortion laws and legal uncertainty are contributing to maternal care deserts. Rural pregnant people experience higher complication rates and must travel up to 100 miles for care. These systemic gaps are producing higher rates of preventable pregnancy-related deaths, particularly in states with large rural populations.

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