Over Half of Missouri Counties Lack Labor and Delivery Services, March of Dimes Reports
A new March of Dimes report finds that more than 50% of Missouri counties are maternity care deserts with no labor and delivery units or obstetric physicians, affecting nearly 140,000 women of childbearing age. Between 2010 and 2024, nine Missouri counties lost hospital-based obstetric services, driven by high fixed costs, low birth volumes, and higher Medicaid patient shares at rural hospitals. Research shows that after rural counties lose obstetric services, risks of preterm birth, out-of-hospital birth, and delivery at facilities without dedicated obstetric units increase. The closures add an average of 25 minutes to travel times for families near affected facilities.
Medicaid covers a disproportionate share of births in rural Missouri, making access gaps and adverse birth outcomes a direct cost and quality concern for the state Medicaid agency and managed care plans serving maternity populations.
Maternal · Managed Care
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