Seeking access to maternal care? Your home address makes a big difference.

More American women are living in areas where they can’t get easy access to maternity care.

More than 5.6 million women live in areas with little or no maternity care services, according to a new analysis released this week by the March of Dimes. Nationwide, about 1 in 10 women don’t live within 30 minutes of a birthing hospital.

About one-third of the nation’s counties (36%) are considered maternity care deserts, because they don’t have hospitals offering obstetric services or have no obstetric providers.

The report offers perspective on a state-by-state level, including those states where patients are traveling greater distances to reach a hospital.

Rural states are more likely to have maternity care deserts, the report shows. Patients in North Dakota must drive more than 32 miles, on average, to reach a hospital providing obstetric services, the greatest distance in the nation. Nearly three-quarters of the state’s counties (71.7%) are maternity care deserts.

Patients in Kentucky must travel 20.3 miles, on average, to a hospital with obstetric services. In South Dakota, the average patient travels 19.5 miles, while in Alabama, the typical patient must go more than 17 miles. Other states with longer distances to hospitals with obstetric services include Alaska (16 miles), Tennessee (15.9 miles), and Mississippi (15.6 miles).

Even among largely rural states, there can be wide variance in access to maternity care services. Wyoming is largely rural, but the average patient must go about 11 miles to a hospital with obstetric services (about a third of the distance as patients in North Dakota).

States with larger populations have shorter travel times, including California (8.3 miles), Texas (8.2 miles), Florida (10 miles), and New York (5.8 miles).

Dr. Elizabeth Cherot, president and CEO of the March of Dimes, says the report illustrates the disparity in maternity care based on geography. She said she hopes the report spurs action to improve access for women.

“A person’s ability to have a healthy pregnancy and healthy birth should not be dictated by where they live and their ability to access consistent, quality care but these reports shows that, today, these factors make it dangerous to be pregnant and give birth for millions of women in the United States,” Cherot said in a statement.

The report notes that some hospitals have stopped offering labor and delivery services, a trend that began before the COVID-19 pandemic. The closure of obstetric units in hospitals led to reduced access to maternity care in 369 counties since 2018, the March of Dimes says.

America’s maternal mortality rate has more than doubled in the past generation, according to a study published last month by the Journal of the American Medical Association. The study found especially disturbing increases among Black Americans and Alaska Native/American Indians, and researchers also found wide variation in mortality rates in some states.

Maternal deaths rose 40% in 2021 compared to the previous year, according to figures released in March by the National Center for Health Statistics. America’s maternal mortality rate has been more than twice as high as other high-income countries, according to the Commonwealth Fund.

Healthcare experts have called for greater attention to maternal mortality and morbidity, since so many deaths are avoidable. More than 80% of America’s maternal deaths can be prevented, according to the Centers for Disease Control and Prevention.

Dr. Irogue Igbinosa, a maternal fetal health specialist at Stanford Medicine Children’s Health, told Chief Healthcare Executive® in a June interview that it’s important to take a closer look at those patients experiencing severe complications, even if they’re not fatal.

“That is actually a more actionable area,” Igbinosa says. “How can we prevent these ‘almost’ events?”