New Research Highlights Critical Link Between Maternity Care Access and Infant Mortality Across the United States

The Alarming Connection Between Maternity Care and Infant Mortality

A recent study published in JAMA Network Open by researchers from March of Dimes highlights a troubling link between the accessibility of maternity care and infant mortality rates across the United States. Analyzing over 18 million births between 2017 and 2021, the report establishes that newborns in counties lacking adequate maternity services are at a significantly higher risk of dying within their first year of life.

Key Findings

The central conclusion of the study indicates that babies born in areas with limited or no maternity care access face a staggering 14% greater risk of death compared to those born in counties with full access to such services. Specifically, researchers noted that infant mortality rates climbed from 5.2 deaths per 1,000 live births in counties with comprehensive maternity services to 6.5 in places where such care is nonexistent.

This disparity emphasizes the crucial role that both availability and quality of maternity care play in ensuring healthy outcomes for both mothers and their infants. Ripley Lucas, an MPH data analyst at March of Dimes, stresses that expanding access alone is not enough—enhancing the quality of care and community support systems is equally important.

Racial and Ethnic Disparities

Examining the results through the lens of maternal race and ethnicity reveals even deeper disparities. Infants born to white mothers in counties devoid of maternity care exhibited a 20% increased risk of mortality compared to their counterparts in full-access counties. In contrast, Black infants faced the most severe outcomes across the board, having mortality rates that exceed those of white infants by more than double, even in areas where maternity care was fully accessible.

These disparities indicate systemic inequalities that prevent marginalized communities from achieving equitable health outcomes, despite advancements in maternity care access.

Timing of Mortality

Furthermore, the study delineates the timing of infant deaths, uncovering that those in no-access counties are at a heightened risk during both the neonatal period (less than 28 days old) and postneonatal period (28 to 364 days old), reflecting variances in the leading causes of death during these phases. Notably, postneonatal deaths, which are influenced by caregiver support and socio-environmental conditions, showcase the widest gaps, with 2.6 deaths per 1,000 live births in counties without access compared to 1.8 in those with full access.

The Need for Systemic Change

This critical research underscores the urgent need to rethink policies and healthcare practices concerning maternity care. It advocates for a holistic approach aimed at not just expanding access but also bolstering community investment, healthcare quality, and supportive resources. Recommendations include workforce development, enhancing hospital capabilities, and establishing community-based programs that strengthen care networks.

March of Dimes is actively engaged in improving maternal and infant health through initiatives like the Mom & Baby Mobile Health Centers®, which deliver essential prenatal and postpartum care to communities with limited access. The organization also champions policies to expand Medicaid postpartum coverage and enhance access to doulas and midwives, while working to address the pervasive structural racism that contributes to health disparities.

In addition, March of Dimes is set to release its annual Report Card next week, which evaluates the state of maternal and infant health across the nation, grading each state on a range of indicators including preterm birth rates and infant mortality, serving as a guide for future policy and program efforts.

Since its establishment in 1938, March of Dimes has been at the forefront of promoting the health of all mothers and babies, dedicated to ensuring that every family receives the best possible start in life.

For further information, visit marchofdimes.org or nacersano.org. Follow March of Dimes on social media at @marchofdimes.