My county’s community hospital has no obstetrics ward. The nearest hospital which does is sixty miles away.

In fact, most of the counties in my state have no capability for labour and delivery or care of newborns. The combinations of low pay coupled with high debt, conservatives unwilling to invest in medical infrastructure, and the lack of profits for a capitalist medical system, combine to create this problem in rural areas of nearly every state of the Union.

In my state’s rural areas, the risk of fatal complications for a mother or newborn are much higher than in cities, also repeated across the country.

Roadside babies, dangerous births part of risk in small town Nebraska (Flatwater Free-Press)

The story of a woman who went into labour and had to go fifty miles to the nearest hospital with an obstetrics ward, and didn’t make it there because her car broke down. Her baby’s place-of-birth has a rather unique entry on the certificate: Mile marker 18.

Some of this could be solved with certified nurse-midwives, but they require supervision by a physician, the very job which is in short supply in rural areas.