By Blake Porter, M.D., Chief of Maternal-Fetal Medicine & Chief Medical Officer of Specialty Services
Access to maternity care continues to shrink in many parts of the country.
The March of Dimes’ 2026 Nowhere to Go: Maternity Care Deserts Across the U.S. report found that one in three U.S. counties is a maternity care desert, with no obstetric clinicians or birthing facilities. More than half of U.S. counties lack a hospital providing labor and delivery services, and at least 96 hospital labor and delivery units closed across 35 states between 2024 and early 2026.
For Blake Porter, M.D., chief of teleMaternal-Fetal Medicine at Access TeleCare, the numbers reflect challenges he sees in clinical practice.
“We see the fallout of this data every day in our clinics,” Dr. Porter said. “When one in three counties lacks maternity care, it means that millions of women are forced to drive hours just for routine prenatal checkups.”
For patients with high-risk pregnancies, including those managing hypertension or diabetes, distance can contribute to delayed diagnoses, missed appointments, and interruptions in ongoing care.
WATCH: Blake Porter, M.D., on Maternity Care Deserts
What Happens When Local Maternity Care Disappears?
Last month, Dr. Porter spoke with FOX 25 Oklahoma City about maternity care deserts and the growing concentration of maternity services in urban areas. He pointed to both clinician shortages and labor and delivery unit closures as contributors to declining access in rural communities.
When a local maternity service closes, the effects extend throughout pregnancy.
Patients may need to drive farther for prenatal visits, take additional time away from work, arrange childcare, and coordinate transportation. March of Dimes found that women in maternity care deserts travel about three times farther, on average, to reach labor and delivery services than women in counties with full access.
The stakes increase when complications arise.
“When an L&D unit closes, that community loses its safety net,” Dr. Porter said. “For a pregnant patient, her entire prenatal routine vanishes.”
A patient experiencing preterm labor, placental bleeding, severe hypertension, or another complication may need to seek care from a hospital without obstetric or maternal-fetal medicine expertise immediately available.
Rural Hospitals Are Facing a Staffing Problem, Too
Maintaining maternity services can be difficult for hospitals serving smaller or geographically dispersed populations.
Low reimbursement, shortages of OB/GYNs and specialized nurses, and the demands of maintaining around-the-clock coverage can place significant pressure on local programs. For hospitals relying on a small number of clinicians, the coverage model itself can become difficult to sustain.
“Expecting one or two local doctors to be on call 24/7 leads to extreme burnout,” Dr. Porter said.
Those workforce challenges matter not only for recruitment, but for retention. Supporting the clinicians already practicing in rural communities is an important part of preserving local access.
Extending the Local Maternity Care Team
Telemedicine gives rural hospitals another way to bring maternal-fetal medicine expertise into the care team without requiring a subspecialist to be physically onsite.
Through teleMaternal-Fetal Medicine, local OB/GYNs, midwives, nurses, and other clinicians can consult with MFM specialists for high-risk pregnancies and complex clinical decisions. That support can help local teams evaluate and manage appropriate patients while also identifying when a transfer to a higher level of care is necessary. Access TeleCare uses this model to support rural hospitals with complex pregnancy care that may otherwise require patients to leave their local health system.
The model also gives hospitals access to subspecialty expertise based on clinical need rather than requiring the fixed staffing costs of a full-time, onsite MFM program.
As Dr. Porter explains, telemedicine can help address both sides of the challenge: giving local clinicians additional clinical support while helping hospitals build more sustainable coverage models.
Keeping Care Available in the Community
Telemedicine will not solve every factor contributing to maternity care deserts. Rural hospitals continue to face reimbursement pressures, workforce shortages, transportation barriers, and other structural challenges. It can, however, expand the clinical resources available to the teams already caring for pregnant patients in those communities.
Dr. Porter recommends starting with the specific pressures facing their organization — whether staffing shortages, financial constraints, clinical coverage gaps, or a combination of factors — and determining where additional specialty support can strengthen the local model.
Because the need for maternity care does not disappear when access does.
“Closing the unit doesn’t stop women from getting pregnant,” Dr. Porter said. “It just makes being pregnant less safe locally.”
