The maternal health crisis in the United States is only getting worse—especially in the South. Despite advances in prenatal care, the region continues to face disproportionately high rates of fetal mortality, poor maternal health outcomes, and dwindling access to care. Now, as Congress debates deep cuts to Medicaid, a new analysis of the Center for Disease Control and Prevention (CDC) data underscores just how dire the situation has become.
According to the CDC, women in the South are now three times more likely to experience late-term pregnancy loss than those in other parts of the country. The average fetal mortality rate for 16 Southern states in 2023 was 6.05 fetal deaths at 20 weeks gestation or later per 1,000 live births and fetal deaths. This compares to an average fetal mortality rate of 5.25 in all other states.
The CDC previously reported that fetal deaths after 24 weeks have been declining since 1990. However, states such as Mississippi, Georgia, and Arkansas continue to have the highest rates.
This new data emerges as Congress considers significant cuts to Medicaid, a lifeline for low income women seeking healthcare. With Medicaid covering over 40% of births in the U.S. — the highest proportion being in the South — these fetal mortality rates are likely to worsen.
The South consistently lags behind in postpartum health outcomes, including higher rates of postpartum depression, fetal mortality, and a shortage of perinatal health workers. The United States of Care, an organization dedicated to expanding access to quality and affordable healthcare, has compiled this data. They urge employers to improve postpartum care for women insured through their plans and emphasize that sustaining and expanding Medicaid access is crucial for improving maternal health outcomes.
These issues also connect to the fact that Southern states have the strictest abortion bans in the country. Such laws have led to an exodus of obstetricians from the region and discouraged young doctors from training in these programs.
Although congressional Republicans have stated they do not intend to cut Medicaid or Medicare, and their budget proposal lacks direct language indicating such cuts, it does request that the Energy and Commerce Committee (responsible for funding these programs) eliminate $880 billion in “waste and fraud” from the system.
Edwin Park, a health policy expert at Georgetown University’s McCourt School of Public Policy, argues that there is not $880 billion worth of waste and fraud in the committee’s budget. To achieve cuts of that magnitude, reductions in Medicaid funding would be inevitable.
The existing proposals would shift more of Medicaid’s financial burden onto states, as its costs are shared between state and federal governments. A cut of $880 billion would translate to an 11% reduction in Medicaid funding overall, potentially leaving an estimated one million people without coverage and millions more with reduced access to care.
Given the clear link between lack of medical access and increased fetal mortality rates, as well as worsened maternal health outcomes, these proposed budget cuts will only make things worse for mothers, infants and families across the country. But some congressional leaders might argue that the safety, health, and prosperity of women and mothers is the perfect example of “waste and abuse.”
