Alabama midwife drives across maternity deserts to serve Black families

Nadia Gramby balances motherhood, marriage and a midwifery practice that spans rural and urban Alabama, where many counties have no hospital labor and delivery services, according to the March of Dimes' latest report. Her firm, Crown of Glory Birth Services, was created in 2018 to fill gaps in care for Black families, and she routinely drives long distances—over 300 miles in one recent day—to attend prenatal visits and births in towns such as Anniston, Montgomery, Helena and Alabaster.

The report highlights that more than 52% of U.S. counties lack hospital-based obstetric care and that 35% are outright maternity deserts, putting millions of women, especially Indigenous and Black mothers, at higher risk of adverse outcomes. Midwives like Gramby, one of about 1,200 Black midwives nationwide, provide personalized, holistic care that can lower cesarean rates and complications. The March of Dimes calls for policy changes to expand midwives' scope and hospital privileges to improve access in underserved regions.