Maternity Care in Rural Areas is in Crisis: Can In-Person Birth Doulas Help?
Maternity care in rural areas of the United States is facing a critical crisis, with a growing number of regions becoming "maternity care deserts." These are areas where there is limited to no access to essential maternity care services, including hospitals with obstetric units, birthing centers, and available obstetric providers. The March of Dimes reports that as of 2024, approximately 2.2 million women of childbearing age live in these deserts, affecting nearly 150,000 births annually. This represents a significant increase in maternity care deserts, with a 5% rise in counties classified as such since 2020 (March of Dimes) (USC Center for Health Journalism).
The factors contributing to this crisis are multifaceted. Rural hospital closures, often due to financial instability, are a primary driver. Over the past decade, more than 200 rural hospitals have discontinued maternity services, leaving large geographic areas without access to critical care. This lack of access not only increases the risk of complications during childbirth but also disproportionately impacts women of color, exacerbating existing health disparities.
Moreover, the reversal of Roe v. Wade in 2022 has also played a significant role in exacerbating the crisis. In the aftermath of the decision, many maternity care providers, particularly those who also provided abortion services, faced legal and financial pressures that forced them to relocate to states with more supportive laws. This exodus of providers has further reduced access to maternity care in states with strict abortion laws, many of which are in rural areas. This shift has left countless women in these regions without local, reliable maternity care options, further compounding the crisis.
The Role of Birth Doulas
Amidst this growing crisis, birth doulas have emerged as an active solution to help bridge the gap in maternity care. A birth doula is a trained professional who provides continuous physical, emotional, and informational support to a mother before, during, and shortly after childbirth. Unlike medical professionals, doulas do not perform clinical tasks; their role is to empower and support the birthing person throughout the process.
Evidence suggests that doulas can play a significant role in improving birth outcomes, particularly in underserved areas. Studies have shown that the presence of a doula during childbirth can lead to a 39% decrease in the risk of Cesarean sections, a 15% increase in the likelihood of spontaneous vaginal birth, and shorter labor times. (Bohren et al, 2017; Gruber et al, 2013) These outcomes are crucial, especially in areas where access to emergency obstetric care is limited.
Furthermore, doulas help reduce the stress and anxiety associated with childbirth, which can have positive effects on both maternal and neonatal outcomes. By providing continuous, personalized support, doulas help mothers feel more in control and supported during childbirth, which is particularly valuable in regions where maternity care resources are scarce.
Stork Club's Comprehensive Doula Program
Recognizing the potential of doulas to address maternity care gaps, Stork Club has developed a comprehensive package that includes both in-person and virtual doula support. Stork Club's Birth Doula Program is designed to offer personalized, continuous support throughout pregnancy, childbirth, and the postpartum period. This program ensures that all doulas are thoroughly vetted and trained, providing high-quality care that can be accessed even in the most underserved areas.
Importantly, Stork Club's program is also ROI positive. By integrating doula services, Stork Club helps reduce Cesarean section rates and the incidence of premature births—both of which are significant cost drivers in maternity care. Reducing these rates not only improves maternal and neonatal health outcomes but also leads to substantial cost savings for both healthcare providers and insurers. This makes the program not only a solution to the care gap but also a financially sustainable approach to improving maternity care outcomes.
Stork Club’s solution goes beyond just providing a doula. The program integrates the support of a doula with access to telehealth services, allowing for continuous care regardless of geographic location. This hybrid model not only addresses the physical presence needed during childbirth but also ensures that ongoing support is available before and after delivery.
This model is particularly well-suited to rural areas, where in-person medical care might be scarce, but virtual support can still offer critical guidance and reassurance. By combining in-person and virtual care, Stork Club’s program presents a scalable solution to the maternity care crisis, offering a lifeline to those in maternity care deserts.