Across the United States, the landscape of maternal health is shifting in dramatic—and sometimes troubling—ways. On one hand, major cities like New York are investing millions to modernize and expand hospital birthing suites, aiming to provide safer, more comfortable experiences for new families. On the other, a growing number of states are seeing their maternity care systems unravel in the wake of restrictive abortion laws, with devastating consequences for both patients and providers.
Just this month, NYC Health + Hospitals/Woodhull broke ground on a $20 million overhaul of its Labor and Birthing Suite, a project designed to serve the diverse communities of North Brooklyn. The renovation, supported by $11 million in borough capital funding, is expected to be completed by fall 2027. Plans include new birthing center rooms equipped with hydrotherapy tubs, an upgraded recovery area, and expanded operating rooms to accommodate advanced equipment and improve workflow. A state-of-the-art simulation lab will help train staff for a range of delivery scenarios, while additional renovations will create more comfortable family spaces, reorganized nurse stations, and enhanced facilities for hospital staff.
"Every family in Brooklyn deserves to welcome their child into the world in a safe, comfortable, and supportive environment," Brooklyn Borough President Antonio Reynoso said, according to Brooklyn Reader. Woodhull Hospital, which recorded nearly 1,000 births in 2024, is one of three city hospitals earmarked for targeted investment in maternal care. The upgrades are part of Reynoso’s broader maternal health agenda, which also includes the creation of the Maternal Health Task Force, funding for education campaigns, and support for community-based programs like the "Born in Brooklyn" baby boxes and the Community Baby Shower Fund.
Reynoso’s office has even partnered with Brooklyn College to launch New York State’s first Advanced Certificate in Perinatal Mental Health, a move aimed at bolstering the expertise of those who care for expectant and new mothers. "At NYC Health + Hospitals, we know that continued investment in our facilities is crucial to the communities we serve. These upgrades to the physical environment of Woodhull’s Labor and Birthing Suite will allow for a higher level of service and experience for the families of North Brooklyn," said Manuel Saez, PhD, Vice President of the Office of Facilities Development at NYC Health + Hospitals.
But while New York City is making strides to improve maternal care, a very different story is unfolding in much of the country. According to a national study published in JAMA on August 30, 2025, states with the most restrictions on reproductive healthcare have seen a 4% drop in OB-GYN practitioners per 100,000 reproductive-age women. In contrast, states without new restrictions saw no decline at all. The study’s findings are stark: since the Supreme Court’s Dobbs decision in 2022, which overturned Roe v. Wade, increasingly restrictive abortion laws have driven OB-GYNs out of affected states, creating what experts call "maternity care deserts." The March of Dimes defines these as any county without a hospital or birth center offering obstetric care and without any obstetric clinicians.
The numbers are sobering. States that have banned abortion saw a 6.7% decline in OB-GYN residency applications during the 2023–2024 cycle, while states where abortion remains legal saw a slight 0.4% increase. This shift suggests that newly minted doctors are increasingly reluctant to train or practice in places where they can’t offer full-spectrum reproductive care. As Beverly Gray, a professor at Duke University School of Medicine, told KFF Health News, "People don’t want to go to a place where evidence-based practice and human rights in general are curtailed."
For many providers, the decision to leave isn’t just about politics—it’s about safety, ethics, and professional integrity. In states like Texas, Tennessee, Idaho, and South Carolina, OB-GYNs have reported working in a state of constant anxiety, fearful of legal retaliation for treating pregnancy emergencies or miscarriages. In fact, 60% of providers say they fear legal consequences, and nearly 40% admit to limiting emergency pregnancy or miscarriage care as a result.
The consequences for patients are profound. In states with restrictive abortion laws, maternal death rates are now 62% higher and perinatal mortality 15% higher compared to states where abortion remains accessible, according to the JAMA study. Early and adequate prenatal care is slipping; in 2023, the percentage of women receiving such care dropped from 77% to 76.1%, while the number receiving no prenatal care at all rose by 5%.
These challenges are especially acute in the South and other politically conservative states. Mississippi, Georgia, Louisiana, Alabama, and South Carolina all report some of the nation’s highest maternal mortality rates. Mississippi’s overall maternal death rate recently hit 82.5 per 100,000 live births, and Louisiana’s stands at about 60.9—both among the highest nationwide.
The racial disparities are even more pronounced. Black women across the U.S. face maternal mortality rates approximately 2.6 times higher than those of white women. In 2022, the national rate for Black women was 69.9 per 100,000, compared to 26.6 for white women. In rural Georgia, the situation is particularly dire: Black women experience maternal mortality rates double those of rural white women and 30% higher than urban Black women.
In New York City, the disparities are similarly stark. The Labor and Birthing Suite upgrades at Woodhull are part of ongoing efforts to address a maternal mortality rate for Black women that is eight times higher than for white women in the city. By investing in hospital infrastructure, staff training, and community programs, city leaders hope to close that gap—but the work is far from done.
Meanwhile, the impact of restrictive abortion laws goes far beyond the procedure itself. These laws are disrupting entire systems of reproductive healthcare by forcing providers out of states, shrinking training opportunities, and undermining the trust between patients and clinicians. Training programs in states where abortion is banned are struggling to maintain accreditation, often requiring residents to travel out of state to complete their education. And for patients, especially those in rural or underserved areas, the growing shortage of OB-GYNs means longer waits, greater travel distances, and sometimes no access to care at all.
One Tennessee doctor, once one of only eight abortion providers in the state, ultimately chose to leave rather than risk prosecution for providing care she considered medically necessary. It’s a story that’s becoming all too common in states with strict abortion bans, where the lines between legal, ethical, and medical obligations have grown increasingly blurred.
As the nation grapples with these divergent paths—one of investment and innovation, the other of restriction and retreat—the stakes couldn’t be higher. Maternal and infant mortality are rising in the states that can least afford it, and the growing provider deficit threatens to deepen already significant health disparities, particularly for communities of color in the South. The survival and dignity of patients nationwide hang in the balance.
