Black women in rural areas face the brunt of declining medical services, including obstetric care, as new federal policies threaten clinic and hospital closures. Under the current White House administration’s summer spending package, federal reimbursement for services covered through Medicaid and the Affordable Care Act severely declined, leaving rural healthcare providers to fend for themselves.
According to the National Rural Health Association, most rural residents live an average of 10.5 miles from the nearest hospital, versus 4.4 miles for their urban counterparts. As of 2022, more than two-thirds of rural hospitals in eight states were without obstetric services. From 2010 to 2022, 12 states reported the loss of 25 percent or more obstetric services in rural hospitals. In North Carolina, 40 percent of counties have no facilities for maternity care.
Nearly 1 in 5, or 20 percent, of rural adults and 40 percent of rural children rely on Medicaid or Children’s Health Insurance Program. Medicaid is the largest payer of maternity care in the country, funding 42 percent of births. Women who enroll in Medicaid in their third trimester have a 4.7 times higher likelihood of experiencing maternal mortality and a 1.5 times higher risk for infant mortality, according to Rep. Nikema Williams’ office. Georgia Rep. Williams introduced the Maternal Health Equity Under Medicaid Act to raise federal matching rates to 90 percent for Medicaid expenditures on maternal healthcare.
The United States remains the only developed country with a rising maternal mortality rate, with deaths skewed toward women of color. Black women are three to four times more likely to die from pregnancy-related complications and twice as likely to lose an infant to premature death. All 50 states were given access to the federal Rural Health Transformation Fund, providing over $100,000 to strengthen healthcare in rural communities. Doulas have stepped in to bridge access gaps, with research suggesting they reduce unnecessary medical procedures and healthcare costs. A study of Medicaid beneficiaries found women receiving doula support had lower cesarean and preterm birth rates.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://afro.com/black-women-maternal-health/