Counties and regions without a hospital that delivers babies are sometimes referred to as maternity care deserts. In West Virginia, the number of counties with a birthing hospital is smaller than the number of counties without one.

Rural areas in the United States have experienced a decline in availability of maternity care, with over 400 closures of obstetric units reported between 2006 and 2020. The West Virginia Maternal Health Scorecard is the first site to map documented obstetric unit closures in West Virginia, along with the stated reason for the closure when provided in news reports or hospital statements. The most common reasons for closures in West Virginia are staffing shortages and financial considerations (e.g. reimbursements rates do not cover the costs of providing obstetric services). Information about additional obstetric unit closures can be sent to for inclusion on the map.

For low-risk pregnancies, midwifery care is associated with fewer interventions, lower cesarean section rates, and higher patient satisfaction. Nationally, 11.4% of births were delivered by a certified nurse midwife. In a 2020 study by the American College of Nurse-Midwives, West Virginia had the smallest number of clinically practicing nurse midwives of any state. The size of the midwife workforce is reflected in the small proportion of births attended by midwives in West Virginia. In 2026, the University of West Virginia for Medical Sciences is starting the state’s first certified nurse-midwife training program.

Access to health insurance is essential to improve maternal health outcomes, as it can influence the use and quality of maternity care. Having health insurance coverage allows pregnant and postpartum women to receive necessary healthcare in the perinatal period without significant financial barriers, thereby promoting maternal wellbeing.