When Ellie started having chest tightness and shortness of breath, she was 37 weeks pregnant and one hour from the closest obstetric hospital. Her blood pressure spiked, according to an at-home test, but she lived in southern Texas hundreds of miles away from medical care. Ellie, who wished to remain anonymous for the purposes of this report, was afraid for the safety of the unborn child and was unsure of what would happen if she took that drive.

With nothing practical to do, she hurried to a local hospital that had closed its obstetrics unit earlier this year.

Ellie’s doctors there determined that she needed to be moved to a hospital that had obstetricians on staff.

She asked to see her own obstetrician, whom she had seen the entire pregnancy, at Texas Children’s Pavilion for Women in Houston. However, Ellie was delivered in error to the incorrect hospital, where she had an emergency caesarean section.

She said, “It was really traumatic.” “The stress of the transfer and being at the wrong hospital and sudden preeclampsia, it was very intense.”

Maternity care in Texas and the United States is becoming worse due to a number of factors, including hospital closures and a shortage of providers.

According to a March of Dimes report from 2023, over one-third of the country’s counties are deemed “maternity care deserts,” meaning they lack access to obstetric providers and/or a hospital or birth centre that provides obstetric care.

The situation is worse in Texas, where 46.5% of the counties are classified as deserts.

According to the report, just 3.8% of women in urban areas of the state live more than 30 minutes from a hospital where they give birth, compared to 28.4% of women in rural areas.

According to the March of Dimes 2022 report, only 7% of obstetricians work in rural areas, and two out of every three maternity care deserts in the nation are located in rural counties.

Since giving birth, Ellie has experienced depression following childbirth. However, Texas Medicaid only covers a person up to the current federal minimum of 60 days postpartum. The state intends to expand that to a year after childbirth—a modification that has already been adopted by dozens of states.

After giving birth, Ellie saw a therapist once, but due to high demand, she was unable to schedule another session before her Medicaid coverage expired. She is unable to pay for services herself.

For mothers’ physical and emotional well-being, postpartum care is crucial, particularly for those with long-term medical issues. According to the March of Dimes, the majority of pregnancy-related deaths are preventable, and one in three occur during the postpartum phase.

As of 2021, the Centres for Disease Control and Prevention report that the maternal mortality rate in the United States was 32.9 deaths per 100,000 live births.

According to the March of Dimes, the nation saw a 3% increase in infant mortality last year, reaching 5.6 deaths for every 1,000 live births—the biggest increase in 20 years. One of the riskiest developed countries in the world to give birth is the United States.

Black women and their offspring have disproportionately high rates of maternal and infant mortality.

Further gaps in care are being experienced by women in dozens of states as a result of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health, which overturned the historic Roe v. Wade abortion decision.