SMFM Special Statement: Opportunities to improve access to maternal‐fetal medicine care in rural and underserved communities

Access to obstetrical and subspecialty maternal-fetal medicine care has continued to decrease in recent years, with a notable obstetrical workforce shortage. Maternity care deserts subsequently lead to worsening perinatal outcomes in these regions. High-risk pregnancies require a higher level of obstetrical care, which is becoming increasingly less accessible. Accessibility is inversely related to adverse perinatal outcomes. This Statement summarizes the health effects of increasing maternity care deserts and geographic disparities, as well as existing programs and initiatives focused on bolstering the healthcare workforce. It also includes specific policy recommendations to improve adverse perinatal outcomes related to the current workforce shortage. Federal medical training programs, programs incentivizing practice in rural and underserved areas, telehealth expansion, and federal and state programs focused on improving maternity care deserts offer solutions to improve the current state of perinatal outcomes; however, it is imperative to increase the maternal-fetal medicine workforce in underserved and rural areas and increase access to subspecialty obstetrical care.