Maternal mortality rates in the United States differ depending on geographic location.
Rural women are almost twice as likely to die from childbirth as those in urban locations.
Several factors contribute to this extreme discrepancy, many of which fall under the social determinants of health.
One driving cause of rural maternal mortality is the lack of access to adequate healthcare services. This issue stems from living in a more remote area. In 2022, the non-profit March of Dimes reported that about 2.2 million women aged 15-44, also known as childbearing age, live in a maternity care desert.
According to the March of Dimes, maternity care deserts are defined as “counties across the U.S. in which access to maternity care services is limited or absent, either through lack of services or barriers to a woman’s ability to access that care within counties” and include regions without obstetrical assistance (March of Dimes).
Due to this, around 40% of women from rural communities must travel farther than 30 minutes to the nearest hospital with maternity services.
Not only do these statistics exemplify the general lack of adequate healthcare resources available to pregnant women in less developed areas, but several studies have also shown that a longer drive time to medical facilities positively correlates to adverse health outcomes. This means that on top of living without sufficient reproductive care, which is essentially a fundamental right, rural mothers suffer consequences even when attempting to seek out medical assistance due to such lengthy travel times.
Rural women do not have higher maternal mortality rates just due to geography. Financial discrepancies in less developed communities also play a role. For example, uninsured rates among mothers are higher in rural areas: 15.4% before pregnancy versus 12.1% in urban areas, 4.6% at birth versus 2.8% in urban areas, and 12.7% postpartum versus 9.8% in urban areas (“Rural Maternal Health Overview”).
These numbers reveal that rural women consistently have less medical coverage during all parts of their pregnancy. This can lead to being unable to pay for and go to as many appointments, causing them to therefore be less healthy before, during, and after pregnancy, putting them at a greater risk for complications.
Similarly, a study of the births throughout 2012-2014 discovered that levels of pre-pregnancy obesity were significantly higher in Black women, unmarried white women, those with less education, and females from rural areas. Unhealthy weight can affect birth outcomes, meaning that this correlates with higher numbers of maternal mortality being present in the mentioned groups.
This also reveals the overlap in maternal mortality disparities, as not only can Black women’s medical treatment be affected due to their race, but also by the consequences of their geographic location as well. Additionally, even if a mother living in a more rural environment wanted to relocate to an urban area with more resources during her pregnancy, she may not have the financial means to do so.
Thus, rural women are often trapped in their situations, continuing this cycle of disparity within maternal mortality rates.
Sources:
Howard, Jacqueline. “US Has the Highest Rate of Maternal Deaths among High-Income Nations. Norway Has Zero.” CNN, Cable News Network, 4 June 2024, www.cnn.com/2024/06/04/health/maternal-deaths-high-income-nations.
“How Pregnancy Affects a Lifetime of Health.” Default, http://www.physiology.org/publications/news/the-physiologist-magazine/2024/november/how-pregnancy-affects-a-lifetime-of-health?SSO=Y. Accessed 2 Dec. 2025.
“Maternity Care Desert.” March of Dimes, Apr. 2025, www.marchofdimes.org/peristats/data?top=23.
“Rural Maternal Health Overview.” Rural Health Information Hub, 19 Mar. 2025, www.ruralhealthinfo.org/topics/maternal-health.
Singh, Gopal K, and Hyunjung Lee. “Trends and Racial/Ethnic, Socioeconomic, and Geographic Disparities in Maternal Mortality from Indirect Obstetric Causes in the United States, 1999-2017.” International journal of MCH and AIDS vol. 10,1 (2021): 43-54. doi:10.21106/ijma.448
Waldman, Hailey, and Alexandra Zimmerman. “Maternal Health in Rural America.” National Rural Health Association White Paper, Feb. 2024. https://www.ruralhealth.us/nationalruralhealth/media/documents/advocacy/white%20paper/maternal-health-in-rural-america-white-paper-final.pdf
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