Nadia Gramby, a certified midwife, travels across Alabama to support families in areas lacking obstetric care as national maternity deserts continue to impact health outcomes.

Nadia Gramby, a licensed professional midwife based in Chelsea, Alabama, travels hundreds of miles to provide prenatal and postpartum care to families in underserved areas. Her work highlights the growing challenge of maternity care deserts in the United States, where over 52% of counties lack hospital-based labor and delivery services. According to a new March of Dimes report, these gaps in care contribute to significant health disparities, particularly for women of color.

The Scope of Maternity Deserts

The latest March of Dimes report, titled "Nowhere to Go," indicates that nearly 35% of U.S. counties are classified as maternity care deserts, meaning they lack both birthing facilities and obstetric clinicians. The report notes that these regions are home to 2.4 million women of reproductive age and see 150,000 births annually. Dr. Michael Warren of the March of Dimes stated that women in these areas face higher risks of poor pregnancy outcomes, as travel times for care can be three times longer than in other regions.

The Role of Midwifery

Gramby, who founded Crown of Glory Birth Services in 2018, is one of approximately 1,200 Black midwives in the U.S. Midwives currently attend about 12% of births nationwide, a 4% increase over the last decade. While research suggests midwife-led births are associated with lower rates of cesarean sections and complications, midwives face regulatory hurdles, including restrictive state licensing requirements and inconsistent insurance coverage. The March of Dimes advocates for policies that would allow midwives to practice independently and gain broader hospital privileges.