When the Nearest Delivery Room Is an Hour Away

Last fall, a small hospital in Lavonia, Georgia, stopped delivering babies. Women in that stretch of the northeast Georgia hills now drive half an hour or more to give birth, and the hospital was plain about one reason why: recent congressional cuts to Medicaid sealed the decision.

Scripture calls children a heritage from the Lord. The women who carry them deserve the same care and protection. Across the South, that care is slipping out of reach, and too many mothers who go into the hospital don't come home.

The South carries the heaviest burden

America loses more mothers to pregnancy and childbirth than any other wealthy nation, and the toll falls hardest here. In 2023, Southern states held the eight highest maternal death rates in the country, from Arkansas and Kentucky to Mississippi and Georgia.

Most of those deaths could have been stopped. Federal reviews find that more than four in five pregnancy-related deaths are preventable. Many trace back to high blood pressure, heart disease or diabetes that went unmanaged because no doctor was close enough to catch them.

Black mothers face the steepest odds. They are close to three times as likely to die from pregnancy complications as white mothers, even at the same income and education levels, and the large majority of rural Black Americans live in the South.

Distance makes everything worse. Roughly a third of U.S. counties have no hospital that delivers babies and no birth center. In those places, a warning sign that a nearby clinic could have caught becomes an emergency on a long highway.

Medicaid keeps the doors open

Medicaid pays for about half of all births in many Southern states and close to half in rural America. For a small-town hospital, that coverage is often what keeps the labor and delivery unit running. Georgetown researchers found that one in three hospitals delivering babies for Medicaid families is rural, and most are more than 40 minutes from the next option. Lose one, and every family nearby inherits a longer drive.

That lifeline is now being cut. The law President Trump signed on July 4, 2025, makes the largest Medicaid cuts in the program's history, about $911 billion over a decade. An estimated $137 billion of that comes out of rural communities, the same places already watching their maternity wards go dark. Nearly 100 labor and delivery units have closed since early 2024, and researchers expect rural access to keep shrinking under the new law.

Coverage before pregnancy saves lives

The South faces a second gap the federal cuts make harder to close. Ten states still have not expanded Medicaid under the Affordable Care Act, and seven of them are Southern. In those states, many low-income women qualify only after they become pregnant, and lose coverage not long after giving birth. The years when a doctor could have treated her blood pressure or diabetes are the years she goes without one.

Expansion changes that, and the results show up in lives saved. A study in Women's Health Issues found expansion states recorded about seven fewer maternal deaths per 100,000 births than non-expansion states, with an even larger gap for Black mothers. A 2026 review spanning more than 60 million births found expansion consistently tied to fewer deaths and fewer life-threatening complications. Rural hospitals in expansion states are also much less likely to be operating in the red, so their delivery rooms are more likely to stay open.

A call to the church

We are called to speak up for those who cannot speak for themselves, and to care for mothers and children alike. In the South today, that means asking our lawmakers to reverse course on cutting Medicaid and to expand it where they have refused. A mother should not have to gamble her life on how far she lives from a delivery room. She should be able to see a doctor long before her baby arrives, and go home with that baby afterward.