It’s becoming ever more dangerous to give birth in America, especially for Black women, older women and those living in rural areas, according to a pair of new reports from March of Dimes and Milken Institute,” reported

“Nationally, the maternal mortality rate in 2021 was 32.9 deaths per 100,000 live births – nearly double the 17.4 deaths per 100,000 live births in 2018, according to the CDC (Centers for Disease Control and Prevention).”

Mississippi, no surprise, had the highest rate among the states at 82.5 mom deaths per 100,000 live births.

Another no surprise, Mississippi still leads the nation in infant mortality.

“Mississippi led the nation with a rate of 10 deaths per 1,000 live births, almost twice the national rate of 5.73,” reported Mississippi Today citing CDC data. Mississippi’s number was 15% higher than the second ranked state, Alabama.

A recent March of Dimes report labeled 42 of Mississippi’s 82 counties “maternity care deserts.” These are counties with no OB-GYNs, certified nurse midwives, or hospitals that offer obstetric care. Another nine counties were deemed “low access” areas. (See state data at

Contributing to the problem are high rates of premature births and low birth weight babies and low breastfeeding rates, categories in which Mississippi also rates the worst compared to other states.

The big picture nationally, said Axios, shows rural communities “struggling with health care access issues that go well beyond maternity care. And many obstetrics unit closures are about money, not politics.”

That’s Mississippi too.

Financially strapped hospitals discontinuing maternity care and emergency rooms, depleted county health departments out of the clinical care business, and struggling rural counties unable to attract certified nurse midwives much less OB-GYNs largely describe the primary problem. Lack of health insurance, limited access to primary care, physician and nurse shortages, and limited transport options help describe larger access challenges.

State Health Officer Dr. Daniel Edney knows the problems but with limited resources can only take baby steps when giant steps are needed. Saving moms and babies requires increased access to obstetrics care – OB-GYNs, trained primary care physicians, certified nurse mid-wives, and birthing centers – in rural county after rural county across the state.

Good luck getting that.

The expansion of Medicaid post-partum insurance coverage earlier this year was a welcome but limited exception to the Legislature’s enduring legacy of indifference to maternal and infant mortality and declining healthcare access in rural areas.

In a different setting, that level of indifference would have been considered depraved indifference given its consequences – dead moms and babies who could have been saved.

Bill Crawford is a syndicated columnist from Jackson.