More than 35 percent of U.S. counties qualify as “maternal care deserts”—areas lacking hospitals offering obstetric care or any obstetric clinicians—and these zones concentrate heavily where Black populations live. Healthcare experts say these gaps aren’t accidents but deliberate disinvestment that harms Black mothers.
The consequences prove deadly. Black women face maternal mortality rates of 50.3 per 100,000 live births, nearly triple the overall U.S. rate of 18.6. This disparity has worsened steadily since 2018, even as overall rates returned to pre-pandemic levels.
Washington, D.C. demonstrates how care deserts create catastrophic outcomes. Black residents account for half the city’s births but 90 percent of maternal deaths. In Wards 7 and 8, where Black residents exceed 80 percent of the population, 64 percent of maternal fatalities occur. Despite being classified as having full access to care, obstetric services concentrate in affluent areas while predominantly Black neighborhoods remain underserved.
Aza Nedhari, co-founder of Mamatoto Village, which provides perinatal care in D.C.’s Ward 7, told the American Public Health Association’s annual meeting that these deserts result from purposeful neglect by healthcare governance systems. March of Dimes Chief Medical Officer Michael Warren agreed, supporting renaming them “maternal care disinvestment zones” to acknowledge their intentional creation.
Systemic racism drives this crisis through social determinants including poverty, inadequate insurance, and chronic stress linked to cardiovascular disease. These factors compound risks for Black women already living in areas stripped of essential maternal healthcare.
See: “Opinion: Maternal care deserts are no accident—they are disinvestment zones harming Black mothers” (January 7, 2026)
