PolicyLab

Many rural Pennsylvania communities have poor access to comprehensive maternal health services to fully support the needs of people who are pregnant and postpartum and their infants. In fact, across the Commonwealth, nine rural counties have no hospital at all, and an additional 23 counties have no hospitals with obstetric facilities. Aside from inadequate services during birth, there are also concerning shortages in prenatal, perinatal, and postpartum physical care and mental and behavioral health supports for people who are pregnant and new parents.  

These care deserts contribute to negative health and birth outcomes for infants and people who give birth. Pennsylvania’s 2022 Maternal Mortality Review Committee report suggests that the drivers of maternal morbidity in the state are primarily related to social determinants of health like substance use, mental health barriers and intimate partner violence. Evidence from the 2020 Family Support Needs Assessment—conducted by PolicyLab—upholds this, pointing to community-level challenges in supporting people who are pregnant and have significant social needs. In comparison to the rest of the state, numerous rural counties have higher proportions of people experiencing postpartum substance use and babies born with neonatal abstinence syndrome, while having few, if any, supportive resources for substance use treatment and mental health services. 

Where the network of health care and social service providers in rural Pennsylvania is sparse, crisis pregnancy centers provide services to people who are pregnant and parenting. These centers may be serving as stand-in providers in areas with inadequate access to prenatal care, particularly for high-need populations experiencing greater social risk. However, it is unclear how crisis pregnancy centers provide services to clients experiencing high needs situations.