The report, titled “From Facilities to Outcomes: A Neighborhood-Level Examination of Maternal and Infant Care Access in Chicago,” highlights the potential impacts of maternity care deserts and measures maternal health care access at a zip code level within the City of Chicago based on three categories: low access, medium access, and full access.

According to the report, low, moderate, and full maternal care access is distributed unequally across the City of Chicago. Most low-access zip codes are located on the south and west sides of the city, while most of the full-access zip codes are located downtown and on the north side of the city.

The report found that since 2018, three OB/GYN facilities that were more convenient for residents of the south and west sides have closed. The number of OB/GYN physicians available to childbearing female residents in those areas ranged from zero to 43, with many of the zip codes on the south and west sides having access to none. These closures require expectant mothers to travel outside their neighborhoods to receive routine or specialty OB/GYN care.

“The health of medically disenfranchised patients and the health of their babies suffer when pregnant patients don’t have access to care in their communities,” said AMA President-elect Bobby Mukkamala, M.D. “With closures of health care facilities compelling patients to travel for necessary care, patients experience worse health outcomes. Accompanying ramifications include a decrease in recruiting new physicians into particular specialties such as emergency medicine, family medicine and obstetrics in these communities. This has created a cycle of disjointed, disconnected care for patients in these neighborhoods, a higher level of burnout for physicians and physicians leaving the profession altogether.”

“This report mirrors what we have found in the March of Dimes national report, Where You Live Matters: Maternity Care Deserts and the Crisis of Access and Equity. Maternity care is simply not a priority in our health care system. Families in more than one-third of counties in the U.S. have no access to maternity care, putting moms and babies at risk for negative birth outcomes," said Chicago March of Dimes Senior Executive Director Ashley Thies. "Steps need to be taken now to ensure all moms receive the care they need to have healthy pregnancies and strong babies."

"Our research underscores the unique challenges of maternal health care access in urban areas like Chicago, where social determinants of health play a crucial role,” said Melissa Gutierrez-Kapheim, Director of Health Equity & Assessment Research at Sinai Urban Health Institute. “The use of neighborhood-level data is essential for effectively targeting our limited resources and measuring impact, allowing us to address maternal health disparities.”

A maternal health care access measure was created for the report by combining three variables at the zip code level: 1) ratio of OB/GYN physicians to women aged 15-44 within a zip code; 2) severe maternal morbidity; 3) hardship index—a measure comprising crowded housing, poverty rate, unemployment rate, adults with a high school diploma or equivalent, age dependency ratio, and per capita income.

The report found that maternal health care access across Chicago coincides with race and ethnicity distribution. Most low-access areas are not only on the south and west sides but also predominantly Black-populated zip codes. The next highest proportion overlapped with majority Hispanic/Latino populations.

Additional findings indicate:

- Obstetric beds in Cook County range from 12 to 134; NICU bed capacity ranges from eight to 86 with most units downtown.

- The Chicago maternal morbidity rate is 74.1 per 10,000 deliveries ranging from 15.6 to 172.8 per 10K by zip code.

- Areas with inadequate prenatal care coincide with few or no registered OB/GYN providers.

- South/west side residency correlates with higher infant deaths/preterm births/low birthweights.

- Facility closures impacted those scoring highest on hardship indexes most severely.

The joint report recommends supporting mothers through virtual appointments bridging gaps left by facility closures; support from foundations/community programs; diversifying/educating an expanded workforce.

We will continue efforts towards equitable maternal/infant healthcare quality.