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Erin Fraher presents to NC General Assembly on the distribution of maternal health care providers

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NC Senators Gale Adcock and Jim Burgin standing next to Erin Fraher in a meeting room.On March 10th, Erin Fraher, PhD, MPP presented to the North Carolina General Assembly’s Joint Legislative Oversight Committee on Health and Human Services on maternal health care access in the state. With the 11th highest infant mortality rate in the US,1 maternal healthcare access is a pressing issue in North Carolina. Erin’s presentation on the distribution and characteristics of obstetric clinicians in the state provided much needed data to inform potential policy solutions to address maternal healthcare access.

 

 

 

Key findings:

  • 81% of births in NC are attended by physicians
  • While the number of physicians providing obstetric care deliveries has increased over time, the number of births per physician has decreased from 135 in 2005 to 101 in 2024
  • There are no clinicians or facilities providing deliveries in 28 NC counties
  • Physicians and certified nurse midwives (CNMs) are concentrated in urban areas; 17 counties with longest travel times have few or no clinicians providing deliveries
  • ~12 and 18 rural hospitals in North Carolina have either closed completely or closed their OB unit in past 12 years. In 2024, nearly 12,000 births originated from these counties
  • 29 states are currently, or in process of, implementing Medicaid reimbursement for doulas;
    NC is not one of them.2 More data are needed on the size, distribution, and characteristics of the NC doula workforce