Protecting the Health of Mothers in the South

As Christians, we know that every child is a gift from God. We also know that a mother's health matters just as much, because a child needs a mother's nurturing and care. Across the South, too many mothers are not making it home with their babies. 

The United States has the highest maternal mortality rate of any developed country, and the American South carries the heaviest share of it. In 2023, the eight highest rates in America all belonged to Southern states: Arkansas, Kentucky, Alabama, Tennessee, Louisiana, Mississippi, South Carolina and Georgia.

The hardest truth is that most of these deaths never had to happen. 84 percent of maternal deaths were caused by preventable health events. Many are caused by underlying conditions like heart disease and diabetes that get worse when no doctor is managing them. The South has more of those underlying conditions than any other region, and fewer doctors close enough to catch them.

Rural mothers face the greatest risk. About a third of the counties in America are maternity care deserts, with no hospital that delivers babies and no birth center. When the nearest labor and delivery unit is an hour away, warning signs get missed and emergencies become tragedies on a long drive.

Black mothers carry the heaviest burden of all. Even after accounting for income and education, Black mothers are nearly three times more likely to die from pregnancy-related complications than white mothers, and more than 80 percent of rural Black Americans live in the South.

Medicaid Cuts Worsen the Crisis

Medicaid pays for nearly half of all births in much of the South, and nearly half of all births in rural America. It is the program that keeps rural maternity wards open. One in three hospitals delivering babies for Medicaid families is a rural hospital, and most sit more than 40 minutes from the next one. When one closes, the next mother in labor drives an hour. As Dr. Katy Backes Kozhimannil, who has studied rural mothers for years, said: "With each rural hospital that closes its obstetric unit, the closest one gets further and further away." She added that it "can change the way a community sees itself when it's a place where babies can no longer be born."

And Medicaid is being cut.

The administration’s Big Beautiful Bill signed on July 4, 2025 makes the deepest cuts to Medicaid in the program's history, $911 billion over ten years. It takes an estimated $137 billion out of rural Medicaid alone, the same rural counties where maternity wards are already closing. Nearly 100 labor and delivery units closed since the start of 2024. And researchers expect rural maternity care to get worse because of the new law.

Expanding Medicaid would be a step toward saving them

On top of the federal budget cuts, ten states have refused to expand Medicaid under the Affordable Care Act, and seven of them are in the South. In those states, a mother is covered only once she is already pregnant, and often only for a short time afterward. The years before pregnancy, when high blood pressure and diabetes could be caught and treated, are the years she goes without a doctor.

Where states have expanded Medicaid, mothers have a far better chance of living. A study in the journal Women's Health Issues compared expansion states with states that refused and found seven fewer maternal deaths for every 100,000 births, and sixteen fewer for Black mothers. A 2026 review of ten studies covering more than 60 million births found expansion consistently linked to fewer life-threatening complications and fewer deaths. Rural hospitals in expansion states are also far less likely to be losing money, which means their maternity wards are more likely to stay open.

Expanding Medicaid could be the difference between a mother being able to return home from the hospital with her child. He asks us to love mothers and their children, and to speak up for those who cannot speak for themselves. For Southern mothers, that means asking our leaders to bring care within reach before a pregnancy begins and long after it ends.