Fifty-two maternity wards in the United States have closed since the federal law known as the One Big Beautiful Bill Act was announced in July 2025, and eight more closures are planned.
The law cuts federal Medicaid funding and adds work requirements, and hospitals have cited both in explaining why they are shutting labor and delivery units. Medicaid pays for about 40 per cent of births in this country. The law’s full financial effect is expected in 2027.
The closures land hardest where there was least to begin with. March of Dimes counts 31 rural hospitals with labor and delivery services now at risk. Its 2026 report counts at least 96 labor and delivery units closed across 35 states between 2024 and early 2026, and in nearly 60 percent of the affected counties the unit that closed was the community’s only birthing facility. Closures pushed average travel time to maternity care up by 25 minutes.
“We’re deeply concerned that these changes already have and will continue to worsen an already serious maternity care crisis,” said Erin Jones, senior director of legislative and strategic counsel at March of Dimes.
About one in three counties in the United States is already a maternity care desert, which the report defines as a county with no obstetric clinicians and no birthing facility. More than half of all counties have no hospital with labor and delivery services at all. The report counts 5.8 million women and 358,000 infants living in counties without full maternity care access, and says people in the deserts travel roughly three times as far as people in full access counties.
There is a second loss stacked on the first, and it is the quiet one. Black women already die of pregnancy related causes at higher rates than other women here. The federal program built to measure what happens to them, the Centers for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System, lost its team to administrative leave in early 2025. Pregnant people on Medicaid can also lose coverage when a state does not know they are pregnant, which means some of the people most exposed to these closures are the hardest to count.
So the ward closes, the drive gets longer, and the instrument that would have told the country what that did to Black mothers is not running. The harm will arrive before the number does, and anybody who goes looking for that number will be asking a question nobody is currently set up to answer.
