Dr. Danielle Martter, an OB-GYN in Union County, has some patients drive more than an hour roundtrip for an appointment.
“It is a struggle because we want to take care of the patients the best we can … but they’re literally constrained by just the fact that they can’t get here,” Martter said.
“So if their car breaks down, or if they only have one car and they can’t make their appointment, they just can’t make their appointment. … It’s frustrating to us.”
Ohio has 24 counties without an OB-GYN, including two that border Union County — Champaign and Hardin, according to the nonpartisan nonprofit KFF, an independent source of research and information on national health issues. The data they used was from 2021.
The 24 counties without an OB-GYN according to KFF are: Adams County, Athens County, Belmont County, Carroll County, Champaign County, Fayette County, Fulton County, Hardin County, Harrison County, Hocking County, Jackson County, Meigs County, Monroe County, Morgan County, Morrow County, Noble County, Ottawa County, Paulding County, Perry County, Pike County, Putnam County, Shelby County, Vinton County, and Wyandot County.
“We do have patients that travel 30 plus minutes from Champaign County, they either travel to us or they travel to Springfield,” Martter said, who has been an OB-GYN in Marysville for 16 years. “There’s also Hardin County, which is a maternity care desert. I have patients that travel from Kenton to see me, which is probably 45-ish minutes.”
Patients might have to take time off work to get to their appointments or might need to get a babysitter to watch their other children. A lot of times patients driving farther distances have to rely on back roads, Martter said.
“There’s no freeway,” she said. “We’re hoping that the roads are safe to travel on, that there hasn’t been an accident that puts them behind even more trying to get back to their job or their children. It does really impact them and their availability to come to us.”
Critical situations can happen during delivery.
“You need to get to a hospital in a pretty short span of time in order to have the baby and mom still be viable, still actually surviving and being not just the baby living in the NICU,” said Maya Dunson, a second-year medical student at Ohio State University.
Those long distances can sometimes prohibit patients from getting prenatal care.
“I have a lot of patients that share a car with their partner, and they can’t always drive the 30 to 45 minutes or afford the gas money to come see us for adequate prenatal care, which obviously affects not only the mom, but the baby at that point,” Martter said.
Despite the challenges, she enjoys practicing in a smaller town.
“There’s something to be said about a small town … and knowing that when you go to the grocery store, you’re going to potentially see multiple patients that you’ve delivered,” she said. “I take care of entire generations of families.”
Nationally, there were 38 practicing OB-GYNs per 100,000 women in the United States and nearly half of the nation’s counties had no OB-GYNs in 2021-22, according to KFF’s data. Nearly 80% of rural counties had no OB-GYNs, according to KFF.
“The biggest issue is obviously access,” said Ohio state Rep. Anita Somani, D-Dublin. “What happens is people don’t get care.”
Telehealth appointments increased in popularity during the COVID-19 pandemic, but the lack of bandwidth in rural areas can get in the way of telehealth appointments.
“They have dial up and so you can’t really have adequate visits with them,” Martter said.
Ohio has 13 counties that are maternity care deserts — meaning they lack hospitals with obstetric care, birth centers and obstetric providers like OB-GYNs, according to the March of Dimes.
“If you’re in one of those areas, you’re traveling anywhere from 20 to 40 minutes to get care,” said Somani, who has been an OB-GYN for more than 30 years and works in Columbus. “It’s going to take a long time to rebuild and improve maternity deserts.”
The 13 counties that are maternity care deserts are Belmont County, Carroll County, Champaign County, Fayette County, Hardin County, Jackson County, Meigs County, Monroe County, Morrow County, Noble County, Perry County, Putnam County, and Vinton County.
“The situation is only getting worse,” said Maya Neidhart, a second-year medical student at Ohio State. “There are still patients in those areas that need access to prenatal care. … Minutes do make the difference.”
Neidhart is from Meigs County and hopes to return to southeast Ohio after graduating to practice as an OB-GYN.
“It has always been my goal to be able to return to the community I’m from and serve it, but it really just depends on if I feel safe to practice in the state,” Neidhart said. “Not having access to abortion care also leads to poor maternal mortality outcomes when people terminate pregnancies in unsafe ways.”
Abortion is legal in Ohio up until 22 weeks of pregnancy. Ohio voters passed a ballot measure in 2023 that added protections to abortion care and reproductive rights to the state’s constitution.
Ohio has six surgical abortion clinics located in Columbus, Cleveland, Cincinnati, Bedford Heights, Cuyahoga Falls, and Dayton. Toledo’s abortion clinic switched to just a medication abortion facility in 2019.
The state had 45 abortion clinics in 1992, Somani said.
“There’s been just a huge decrease in a lot of those clinics,” Somani said. “The bigger problem is, when you restrict abortion, you can’t train the next generation to be able to do the care that they need to.”
Dunson and Neidhart are both members of Medical Students for Choice, an international advocacy organization focused on educating medical students about reproductive health care, including abortion. They have more than 300 chapters on medical school campuses.
“Med Students for Choice is there to make sure that medical students get the training that they need to become abortion care providers,” Neidhart said. (Abortion is) part of full spectrum obstetric and gynecology care, so it’s absolutely something that it is health care, and it’s needs to be part of the conversation when we’re talking about access to reproductive health care.”
Originally published by the Ohio Capital Journal. Republished here with permission.