By Leah Shepard / Broadcast version by Nadia Ramlagan reporting for the Kent State-Ohio News Connection Collaboration.

In Ohio, 13 of 88 counties are maternity care deserts, affecting approximately 97,000 women, according to data provided by March of Dimes. 

A county is classified as a maternity care desert if there are no hospitals providing obstetric care, no birth centers, no OB-GYN’s and no certified nurse midwives, according to March of Dimes. Bianca Zarders, maternal and infant health manager for the Cleveland Market Branch of March of Dimes, said 4,118 babies were born last year to Ohio mothers who live in maternity care deserts.

“In Ohio and on a national scale, a lot of the research shows that a lot of these women may have to drive 30, 40, 50 minutes to get to their nearest birthing hospital,” Zarders said. “And that is so problematic too, because if they’re struggling to pay for gas, or they have multiple kids who are at day care or in school, finding just the time to actually go to a prenatal appointment or to give birth and having to drive 50 minutes to get somewhere is insane.”

The dearth of maternity care in the state is getting worse, said Natasha Takyi-Micah, public policy and external affairs associate at the nonprofit Center for Community Solutions in Cleveland.

“And a few weeks ago, University Hospitals in Ashland announced that they were closing their maternity department,” Takyi-Micah said. So pretty much, that county does not have any hospitals that offer labor and delivery services unfortunately.”

The closing of the maternity department at Ashland comes eight months after University Hospitals closed their maternity department in Portage County in order to consolidate labor and delivery services at UH Geauga Medical Center in Geauga County. 

In a press release, University Hospitals said that declining birth rates and staffing shortages are both reasons for the closing the maternity department in Portage County. They said in July that the Ashland branch is closing for the same reasons. 

“The reason why a lot of hospitals are closing their labor and delivery departments or maternity wards is because of what happened during the pandemic,” Takyi-Micah said. “It seems the pandemic exacerbated many problems that came to staff shortages in the hospitals, and also there was a decline in births.”

Dr. Maria Phillis, an OB-GYN and member of the American College of Obstetricians and Gynecologists, said maternity care deserts force some patients to travel unusually far for appointments, especially if they need specialized care.

“One of our notable things we have to fill gaps for is higher-level care,” she said. “So for example, at one of the institutions that I’ve worked at, we had a patient with significantly poorly controlled diabetes who was coming essentially more than an hour and a half for high-risk appointments and wasn’t able to routinely travel that distance.”

Phillis said that many of these patients travel from very rural areas where obstetric care is unavailable.

Zarders, who works in research, policy and legislation for the March of Dimes as well as community outreach, said the lack of maternity care coupled with chronic health conditions, like diabetes, hypertension and smoking, often lead to poor childbirth outcomes and preterm births.

She said other widespread issues affect whole communities. 

“Another overarching theme is community level issues,” Zarders said. “Like socioeconomic status or environmental factors. Those also fuel the disparity when it comes to receiving adequate prenatal care, especially in communities of color.”

Zarders said that at some hospitals, women are turned away entirely because of lack of care, and that this is something that happens on a national scale.

“I recently heard a story where a woman ended up in an emergency room because she was in labor,” Zanders said. “And the nearest hospital just had an emergency room. And she was actually denied care because they didn’t have an OB person present. And so they actually asked her to go to another hospital.”

Takyi-Micah said the Center for Community Solutions is working to influence policy at the state level to alleviate this problem. 

“We just wrapped up the state budget,” she said. “We have been advocating for doulas to be reimbursed through Medicaid so more people have access to them, since they are one of the solutions to reduce the infant and maternal mortality crisis. So, that language is now included in the budget.”


This collaboration is produced in association with Media in the Public Interest and funded in part by the George Gund Foundation.


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United States Secretary of Health and Human Services Xavier Becerra and U.S. Rep. Yadira Caraveo - D-Thornton - recently paid a visit to Salud Family Health Centers' mobile clinic.

Each year, Salud serves up to two thousand migrant farmworkers who travel from other states and countries to plant and harvest leafy greens, corn, wheat, sugar beets, and other crops in North Central and Northeastern Colorado.

Director Deborah Salazar said her team always gets a very warm welcome.

"And it's usually the same guys that come to the same farms or greenhouses," said Salazar. "And so it's like seeing old friends. They know who we are, they know what we can do for them, and they trust us. There is trust because we have been doing this for a very long time."

In addition to its 12 brick and mortar health centers, and ten school sites, the mobile unit provides primary health services three to four evenings per week - primarily in rural areas.

They screen workers for diabetes, hypertension, cervical cancer, and anemia. Workers can also get lab tests, and flu and tetanus vaccines.

Salud is a federally qualified community health center that provides medical, dental, pharmacy, and behavioral health care services to all patients regardless of their ability to pay.

The first clinic on wheels was acquired in 1980, and Salazar said a brand new unit was rolled out in 2022.

She said her team works to build relationships with farm owners and supervisors to find the best time to plan a visit.

"If they need us to come out and start our visit on the mobile unit at 7 p.m, we can do that," said Salazar. "We are super flexible, because we don't want to interrupt their work day."

Salazar said the medical staff on the mobile unit might be the only people migrant workers see when they are not out planting and harvesting crops.

"These are the folks that put food on our table," said Salazar. "To give them quality, integrated health care - and go to them, so that they are taken care of - this is the least we can do."




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After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.