By Leah Shepard / Broadcast version by Nadia Ramlagan reporting for the Kent State-Ohio News Connection Collaboration.

In Ohio, 13 of 88 counties are maternity care deserts, affecting approximately 97,000 women, according to data provided by March of Dimes. 

A county is classified as a maternity care desert if there are no hospitals providing obstetric care, no birth centers, no OB-GYN’s and no certified nurse midwives, according to March of Dimes. Bianca Zarders, maternal and infant health manager for the Cleveland Market Branch of March of Dimes, said 4,118 babies were born last year to Ohio mothers who live in maternity care deserts.

“In Ohio and on a national scale, a lot of the research shows that a lot of these women may have to drive 30, 40, 50 minutes to get to their nearest birthing hospital,” Zarders said. “And that is so problematic too, because if they’re struggling to pay for gas, or they have multiple kids who are at day care or in school, finding just the time to actually go to a prenatal appointment or to give birth and having to drive 50 minutes to get somewhere is insane.”

The dearth of maternity care in the state is getting worse, said Natasha Takyi-Micah, public policy and external affairs associate at the nonprofit Center for Community Solutions in Cleveland.

“And a few weeks ago, University Hospitals in Ashland announced that they were closing their maternity department,” Takyi-Micah said. So pretty much, that county does not have any hospitals that offer labor and delivery services unfortunately.”

The closing of the maternity department at Ashland comes eight months after University Hospitals closed their maternity department in Portage County in order to consolidate labor and delivery services at UH Geauga Medical Center in Geauga County. 

In a press release, University Hospitals said that declining birth rates and staffing shortages are both reasons for the closing the maternity department in Portage County. They said in July that the Ashland branch is closing for the same reasons. 

“The reason why a lot of hospitals are closing their labor and delivery departments or maternity wards is because of what happened during the pandemic,” Takyi-Micah said. “It seems the pandemic exacerbated many problems that came to staff shortages in the hospitals, and also there was a decline in births.”

Dr. Maria Phillis, an OB-GYN and member of the American College of Obstetricians and Gynecologists, said maternity care deserts force some patients to travel unusually far for appointments, especially if they need specialized care.

“One of our notable things we have to fill gaps for is higher-level care,” she said. “So for example, at one of the institutions that I’ve worked at, we had a patient with significantly poorly controlled diabetes who was coming essentially more than an hour and a half for high-risk appointments and wasn’t able to routinely travel that distance.”

Phillis said that many of these patients travel from very rural areas where obstetric care is unavailable.

Zarders, who works in research, policy and legislation for the March of Dimes as well as community outreach, said the lack of maternity care coupled with chronic health conditions, like diabetes, hypertension and smoking, often lead to poor childbirth outcomes and preterm births.

She said other widespread issues affect whole communities. 

“Another overarching theme is community level issues,” Zarders said. “Like socioeconomic status or environmental factors. Those also fuel the disparity when it comes to receiving adequate prenatal care, especially in communities of color.”

Zarders said that at some hospitals, women are turned away entirely because of lack of care, and that this is something that happens on a national scale.

“I recently heard a story where a woman ended up in an emergency room because she was in labor,” Zanders said. “And the nearest hospital just had an emergency room. And she was actually denied care because they didn’t have an OB person present. And so they actually asked her to go to another hospital.”

Takyi-Micah said the Center for Community Solutions is working to influence policy at the state level to alleviate this problem. 

“We just wrapped up the state budget,” she said. “We have been advocating for doulas to be reimbursed through Medicaid so more people have access to them, since they are one of the solutions to reduce the infant and maternal mortality crisis. So, that language is now included in the budget.”


This collaboration is produced in association with Media in the Public Interest and funded in part by the George Gund Foundation.


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Amid a nationwide shortage of respiratory therapists, an "earn while you learn" initiative is underway to build a skilled workforce in Virginia to meet growing respiratory care demands.

Sentara Health and Tidewater Community College have launched a respiratory therapy apprenticeship program, which covers educational expenses of nearly $18,000 over two years, while providing hands-on experience at Sentara Norfolk General Hospital.

Kristian Vasconcellos, one of the program's first apprentices, likes the linking of the classroom to the workspace.

"You know, us cleaning the vents or cleaning the machines or the equipment, I do get that experience of being in school and saying, 'Oh my gosh, I know what that is, I know how this works,'" Vasconcellos explained.

Students spend 32 hours each week in academic and clinical training and an additional eight hours working at the hospital, where they encounter a range of real-world medical situations involving asthma, sleep apnea and others. Industry experts have noted a growing need for respiratory therapists, especially following the COVID-19 pandemic, which has led to increased worker burnout and hospital staffing shortages.

Tara Almony, manager of respiratory care and pulmonary diagnostics at Sentara Norfolk General Hospital, expressed enthusiasm about the program's potential to ease the staffing shortage and prepare students for the realities of the job.

"We were looking and thinking outside the box of how we could be creative and how to bring respiratory therapists in, help them," Almony outlined. "Then also, how we as a Norfolk General could help them grow and kind of create a pipeline for ourselves in a way. "

The demand for respiratory therapists has surged, with the U.S. Bureau of Labor Statistics projecting a 14% increase in job openings by 2031. The median annual salary for a respiratory therapist is currently $77,960.


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A Wyoming helpline connects callers to a variety of health and human services, including help with health insurance during open enrollment.

Olivia Schon, deputy director of Wyoming 211, said the service fields 20 to 30 calls a day. Specialists then connect callers with appropriate resources from a database of nearly 3,000 options, ranging from small nonprofits to state and federal programs.

Schon pointed out the top issues people call about are rent and utility payment assistance programs, food insecurity and transportation to health providers. She noted initial conversations often unveil more areas in which the caller can use assistance.

"We average four times the amount of referrals going out based on phone calls coming in," Schon reported. "They call with what their first issue is and then they leave with more than one solution to other problems that they also have going on."

When callers need assistance enrolling in health insurance, they're connected with Wyoming 211's "sister program," Enroll Wyoming. Open enrollment starts Friday.

The rate of health insurance enrollment in Wyoming through the marketplace has increased 75% since 2020, according to KFF. In a round of federal funding announced in September for health insurance navigators, Enroll Wyoming received a $1.5 million grant to continue offering its services for free.

Caleb Smith, marketing director for Enroll Wyoming, said making important decisions around health care can be intimidating.

"It doesn't hurt to have somebody who's on your side," Smith explained. "Who's willing to act as an advocate for you to make sure that you have your questions answered, that you have what you feel like you need to be able to make an informed, empowered decision."

Wyoming 211 is available by dialing 211 from any phone in the state.

The Northern Virginia Dementia Care Consortium will host its annual conference on Saturday - bringing together caregivers, medical experts, and community organizations to address the growing needs of dementia caregivers.

The conference in Fairfax titled "Navigating the Journey: Adjusting the Sails in Dementia Caregiving" is billed as the region's largest event of its kind.

Dr. Nicole T. Rochester is keynote speaker and founder of Your GPS Doc.

She said she knows the challenges of caregiving firsthand, and reflects on her experience caring for her father - alongside her two sisters - during the last three years of his life as he battled vascular dementia.

"It literally, to this date, is the hardest thing that I've ever done, and I've done a lot of difficult things in my life," said Rochester. "But it was also a very beautiful and meaningful and transformational experience for me."

Rochester said she hopes her talk will offer "hope and inspiration" to other caregivers. Anyone interested can register for the conference on the Northern Virginia Care Consortium website.

The event will also feature Dr. Jennifer Pauldurai, a cognitive behavioral neurologist at Inova Parkinson's and Movement Disorders Center, who will address common misconceptions about dementia.

"There is no one algorithm, no one picture of dementia," said Pauldurai, "one person who gets dementia is going to look completely different one hour, one minute, one year, than they did the year before."

Her presentation will offer practical strategies for managing the complexities of dementia care. Both presenters emphasize the importance of caregivers taking care of themselves.

Attendees will also hear from financial and legal planning experts, hospice care providers and nutrition experts.

Amber Nightingale, associate state director for community outreach with AARP Virginia - whose organization is a long-time conference supporter - said every attendee will receive a copy of The 36-Hour Day, a comprehensive guide to dementia care.

"If we can help support the family caregivers who are looking for up-to-date information and resources, and information on treatment, support services," said Nightingale, "then we're happy to support such a conference."

According to the Virginia Department of Health, 150,000 people aged 65 and older are living with Alzheimer's in the state, and around 10% of people aged 45 and older have subjective cognitive decline.