Michael Warren, MD, MPH, FAAP, warns of worsening US maternal care

In a recent discussion with Contemporary OB/GYN, Michael Warren, MD, MPH, FAAP, Chief Medical and Health Officer of March of Dimes, highlighted significant concerns about the current state of maternal care in the United States, emphasizing the critical issue of access.

March of Dimes’ 2024 Maternity Care Desert Report revealed that more than one-third of US counties qualify as maternity care deserts—areas without obstetric providers, including OB-GYNs, family physicians who deliver babies, or midwives, and without hospitals or birthing centers offering maternity services. While these deserts are more common in rural regions, they are not exclusive to them. Warren noted that individuals living in these areas must travel significantly farther to receive prenatal or delivery care and face a higher likelihood of adverse outcomes for both mother and infant.

Warren underscored that the United States remains one of the most dangerous high-income nations for giving birth, and the widespread presence of maternity care deserts further compounds this challenge. He expressed concern that policy changes on the horizon may increase the number of affected counties, exacerbating access gaps.

In addition to structural barriers, Warren highlighted rising rates of chronic conditions among pregnant individuals—including diabetes, hypertension, and obesity—as another major area of concern. These conditions, often present long before pregnancy, are closely linked to birth outcomes, underscoring the importance of proactive disease prevention and management across the life course.

To improve care for new mothers, Warren emphasized the essential role of obstetric providers in ensuring early and consistent prenatal care, timely screening for risk factors, and appropriate referral to specialty or higher-level care when necessary. However, he stressed that clinical care alone cannot solve the nation’s maternal health challenges.

Broader public health efforts must work in tandem with clinical care to support maternal wellbeing. This includes ensuring safe environments for physical activity, improving access to nutritious foods, supporting immunization uptake, and expanding community-based services such as public health home visiting programs—each shown to strengthen maternal and infant health outcomes.

Warren closed by reaffirming March of Dimes’ commitment to advancing maternal and infant health despite the discouraging D+ national grade for preterm birth. He highlighted the organization’s recent opening of its sixth Prematurity Research Center, this one in Texas through a collaboration between Galveston and UT Southwestern, aimed at advancing understanding of the causes of prematurity.

The organization is also deploying mobile access vans nationwide to help address care deserts. Warren emphasized that sustained collaboration with obstetric providers is essential to ensuring every mother is healthy and every baby has the strongest possible start.

This video is part 2 of a 2-part series. Click here for part 1.

No relevant disclosures.

Reference

Lucas R, Thames T, Chestnut JF, DeMaria AL, Stoneburner A. Maternity care access and infant mortality. JAMA Netw Open. 2025;8(11):e2542831. doi:10.1001/jamanetworkopen.2025.42831