What happens when maternity care deserts stop being just a “rural problem” and start impacting your own labor and delivery unit? On this episode of BackTable Women’s Health, host Dr. Nicole Faulkner interviews Dr. Yamicia Connor about the evolving “birth worker crisis.” Dr. Connor reframes the issue as a long-standing structural collapse accelerated by deliberate policy decisions, not simply sudden burnout.

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Timestamps

00:00 - Introduction
03:30 - Structural Collapse Explained
05:41 - What Providers Can Do
09:40 - Data On Care Deserts
14:24 - COVID Like System Failure
19:50 - Limits Of Telehealth
20:57 - Think Systemwide Care
23:52 - Insurance Access Shifts
25:04 - Support Midlevel Workforce
27:06 - Build Future Infrastructure
29:39 - Burnout Is System Failure
31:02 - Defunding Surveillance Risks
32:51 - Stop Calling It Burnout
34:35 - Conclusion

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More about this episode

Dr. Connor describes how the systematic decoupling of clinical science from federal and state infrastructure has shifted legal and operational risk onto individual physicians, leading to illogical practice patterns and confusion about the standard of care, especially in settings like emergency departments. A review of the 2024 March of Dimes data showing over 35% of U.S. counties are now maternity care deserts, and JAMA-tracked data in states like Idaho, where nearly a third of OBs left between 2022 and 2024. She warns that as more rural units close, regional and academic hospitals will absorb sicker and less managed patients, straining L&D units, NICUs, staffing, and training pipelines. To address this crisis, Dr. Connor calls for system-level coordination, stronger leadership from professional societies, improved care navigation, expanded mid-level support, and enhanced telehealth infrastructure to extend obstetric expertise.

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Resources

Maternity Care Deserts Across the US https://www.marchofdimes.org/maternity-care-deserts-report

Change in Number of OB/GYN Physicians Practicing Obstetrics After the Dobbs Decision https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2837058

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BackTable OBGYN is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women’s health.

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