May 24, 2022 - News

North Carolina's maternity care deserts

Illustration: Gabriella Turrisi/Axios

Millions of women in states across the country don't have easy access to obstetric care, and North Carolina is no exception.

Nearly 30% of counties in the state don't have an OB, per the Health Resources & Services Administration, Axios Charlotte's Ashley Mahoney reports.

Why it matters: North Carolina legislators are considering health care policies that some people say could ease this problem.

  • Those policies include Medicaid expansion, which would cover some of the state's poorest residents, including in rural parts of the state.
  • Another measure, called the SAVE Act, would allow advanced practice registered nurses to practice without physician supervision. If signed into law, the SAVE Act, which is supported by a majority of Republican and Democratic lawmakers, could lower health care costs and make it easier for nurses to serve in more rural parts of the state.
  • Another policy included would change requirements for health care facilities seeking to provide services. That could expand health services to rural communities, proponents say.

What they're saying: "Many of us who serve in the state as nurse midwives do it with a very strong passion to reach people who live more rurally, to provide education and improve maternal child outcomes, ... to decrease the number of C-sections, to increase the breastfeeding rates, to increase birth weights, particularly in populations of high risk," said certified nurse midwife Margaret Fryer, who serves on the North Carolina Nurses Association's Board of Directors.

  • "We have health departments in rural areas that could really use nurse midwives and could be opened up to provide prenatal care. We also have women that have to drive great distances."

Yes, but: North Carolina is not among the states with the worst access to care as far as maternity care deserts go.

  • Red states poised to ban or severely limit abortion already tend to have limited access to health care, Axios' Caitlin Owens recently reported.
  • More than a dozen states have a higher percentage of maternity care deserts than North Carolina does.

By the numbers: Durham County has 100 OBs for a population of 327,306, per HRSA.

  • Neighboring Orange County, which includes Chapel Hill, has 63 OBs for a county population of 149,077.
  • Wake County has 152 OBs for a population of more than 1.1 million.
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