Imagine being eight months pregnant and finding out that the hospital where you planned to deliver your baby is closing its maternity ward. Now you need to find another hospital, and who knows how far that will be from your home? You may need a new delivery plan and someone who can get you there when labor begins.
And if something goes wrong before your due date, where do you go?
For a growing number of families across the United States, these aren’t hypothetical questions.
Since July 2025, 52 maternity wards have closed nationwide, with another eight closures announced, according to an analysis by the health advocacy organization Protect Our Care cited in an October 11 report by The Guardian.
The closures come as hospitals prepare for changes to federal Medicaid funding and eligibility rules. Some facilities have already cited anticipated Medicaid policy changes as a factor in their decisions to stop providing maternity services.
For Black women, who already face disproportionately high maternal mortality rates, the shrinking availability of obstetric care raises another concern: What happens when getting medical attention during pregnancy becomes even harder?
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Hospital maternity units have been disappearing for years, particularly in rural communities where hospitals may struggle to maintain enough staff and funding to provide labor and delivery services.
The latest March of Dimes maternity care report, released in August 2026, found that approximately one in three U.S. counties is considered a maternity care desert. That means the county has no birthing facility or obstetric clinician available to provide maternity care.
The report also found that:
The problem extends beyond communities with no maternity services: some areas have hospitals but lack sufficient obstetric providers to meet patients’ needs.
A woman may technically have access to a hospital while still facing long appointment waits, transportation difficulties, or limited options for specialized pregnancy care.
RELATED: Why is the Black Infant Mortality Rate So High?
Running a labor and delivery unit requires a lot more than some may assume. Hospitals need nurses, obstetric clinicians, anesthesia services, emergency equipment, and the ability to respond to complications around the clock. Those services can be expensive to maintain, especially in communities with fewer births and hospitals operating on tight budgets.
Medicaid is also an important part of the financial picture. The public insurance program pays for approximately 40 percent of births nationwide, according to The Guardian. That means changes to Medicaid financing can have significant consequences for hospitals that provide maternity care.
A federal law enacted in July 2025 includes major changes to Medicaid eligibility beginning January 1, 2027. Certain adult beneficiaries will be required to document work or other qualifying activities, while states will generally have to renew Medicaid eligibility for adults covered through the Affordable Care Act expansion every six months instead of annually.
Pregnant women and those receiving Medicaid postpartum coverage are exempt from the New York requirements. However, KFF, a nonprofit health-policy research organization, warns that states may not have enough information to identify everyone who qualifies for an exemption, creating potential administrative hurdles for eligible enrollees.
And even when a pregnant woman’s coverage is protected, her hospital may still face financial pressure if Medicaid revenue declines or the number of uninsured patients increases.
The new Medicaid changes did not cause every maternity-ward closure. Staffing shortages, declining birth volumes, existing financial difficulties, and other factors have contributed to closures for years.
But researchers and maternal health advocates warn that additional financial pressure could make it harder for some hospitals to keep their maternity units operating.
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The United States already has a serious maternal mortality problem, and Black women experience a disproportionate share of it. According to the Centers for Disease Control and Prevention (CDC), the maternal mortality rate for Black women in 2024 was 44.8 deaths per 100,000 live births, compared with 14.2 for white women.
Those differences reflect longstanding problems in access to care, quality of care, and broader social conditions that affect health. Losing a nearby maternity unit can add another obstacle.
Think about a woman who works an hourly job, doesn’t own a car, and has other children at home. A prenatal appointment that once required a short trip may now involve arranging transportation, taking additional time off work, and finding someone to watch her children. If her pregnancy becomes complicated, she may need more frequent appointments or care from a specialist even farther away. And when labor begins, getting to the hospital isn’t always something that can be easily scheduled.
These challenges aren’t unique to Black women, and maternity-ward closures affect families of many backgrounds. But they can compound existing inequities for Black mothers who already encounter barriers to timely, high-quality maternity care.
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Labor doesn’t always follow a predictable schedule. Some women deliver quickly, while others have a longer labor process. Other women experience complications such as heavy bleeding, severe high blood pressure, or decreased fetal movement that require urgent medical attention.
If the nearest maternity hospital is farther away, getting timely care can be more challenging, especially for women with high-risk pregnancies.
Not every emergency department is equipped to handle childbirth complications. Hospitals without dedicated maternity units may be able to assess and stabilize patients, but their obstetric resources vary.
That’s why it’s important to have a labor and delivery plan (see below for tips on creating your own plan) and know ahead of time where to go for both routine delivery and pregnancy-related emergencies.
RELATED: Why Black Women Feel Unsafe Giving Birth
If you’re pregnant and learn that your hospital is closing its labor and delivery unit, don’t wait until your due date to make another plan.
Here are five steps to discuss with your healthcare team.
Ask your obstetrician or midwife which hospital they recommend and whether they have privileges to deliver babies there. Don’t assume that because your provider continues seeing patients, they’ll automatically be able to deliver your baby at another facility.
You may be able to continue regular appointments with your current provider even if your delivery hospital changes. But if you need specialized care, additional monitoring, or a different clinical team, ask how they’ll handle referrals and medical records.
Regular prenatal care remains important throughout pregnancy, so make sure your appointments continue without interruption.
Find out how long it takes to reach the new hospital at different times of day.
Also think about:
Ask your healthcare team or Medicaid plan whether non-emergency medical transportation is available for covered appointments.
Your provider should explain which symptoms require immediate evaluation and where to seek care. Know the urgent maternal warning signs, including severe headaches, heavy bleeding, and changes in your baby’s movement, and seek medical care immediately if they occur. If you’re experiencing a medical emergency, call 911 immediately.
Confirm that your new hospital and maternity care providers participate in your insurance plan. If you have Medicaid, make sure your pregnancy information and contact details are up to date with your state Medicaid agency or health plan.
If you need to apply for Medicaid or CHIP, HealthCare.gov explains how to get started.
Hospitals, health systems, and community organizations are exploring different ways to improve maternity care and access. Some communities are expanding midwifery services, mobile prenatal care, telehealth support, and transportation assistance.
Others are working to strengthen the maternity care workforce or create regional partnerships so smaller hospitals can connect patients with higher-level obstetric services.
These approaches are helpful but still have limitations. A mobile clinic may help someone get prenatal checkups closer to home, but it cannot replace a fully staffed hospital when emergency childbirth care is needed.
As we’ve covered at BlackDoctor, federal lawmakers have introduced proposals including the Mamas First Act and CARE for Moms Act, which are looking to expand access to maternal healthcare and strengthen support for providers.
As of this writing, we’re not sure whether those efforts will be enough to prevent further closures.
RELATED: Black Midwife Builds First Freestanding Birthing Center
Finding a hospital that can safely deliver your baby shouldn’t be another obstacle during pregnancy. But as maternity wards close, more families face longer trips to get the care they need.
For Black women, who already face significant maternal health disparities, access to timely, high-quality care is especially important.
If your local maternity services are changing, talk with your healthcare team, make a plan and know where to go in an emergency.
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