Nadia Gramby cherishes quiet moments with her baby girl River Emmanuel, who's starting to talk.They exchange snuggles and baby coos each morning."Did you sleep well last night?" Gramby asks her little girl, who has dark curls and a big smile.Besides being a mother of two and a wife, Gramby spends her days and many nights as a midwife caring for other moms and babies across Alabama where she lives and practices.For stories on the science of healthy living, subscribe to NPR's Health newsletter.The kind of care Gramby offers is important because more than 52% of counties in the U.S.
do not have hospital-based labor and delivery services, according to the latest March of Dimes "Nowhere to Go" report on maternity care deserts, out Tuesday.The 2026 report also finds one in three counties, or nearly 35%, are maternity care deserts, meaning they have no birthing facilities or obstetric clinicians."This goes beyond a mere inconvenience," said Dr.
Michael Warren, chief medical and health officer for the March of Dimes."We know that those women who live in maternity care deserts are more likely to have bad outcomes when it comes to their pregnancies."More than 20,000 babies die before their first birthday every year in the U.S., according to the Centers for Disease Control and Prevention.
And about 600 women a year don't survive pregnancy-related complications.The risks are heightened for women of color, according to the most recent maternal mortality data from the March of Dimes and the CDC.Rates of maternal death are significantly higher for Indigenous and Black women than for white women.On any given day, the midwife Gramby may drive hundreds of miles through cities and sprawling rural towns in Alabama, to help families bring new life into the world.
She's a licensed and certified professional midwife based in Chelsea, a suburb of Birmingham.Gramby says traveling long distances to support patients is worth every mile."It is an amazing joy to see families who feel safe,...