Geographic Disparities in Obstetric Care Access in the United States.

Abstract

Understanding the distribution of obstetrician-gynecologists (ob-gyns) is crucial to combatting inequities in care access throughout the United States. In this cross-sectional study, we used data from the Health Resources & Services Administration to characterize counties with and without ob-gyns. Of the 3,143 U.S. counties analyzed, 1,473 (46.9%) did not have a single ob-gyn. Counties without ob-gyns were more likely to be nonmetropolitan (57.5% vs 44.6%, P <.01), have a lower median household income ($52,989 vs $59,470, P <.01), and have a greater proportion of White residents (87.6% vs 79.0%, P <.01). Notably, only 103 (7.0%) counties without an ob-gyn had any midwives. Inequities in maternity care provision remain a significant issue in the United States, creating a need for creative policy solutions to improve access.