In Dobbs’ Aftermath, New Report Examines Maternity and Infant Care Capacity of Community Health Centers

Researchers at GW found that already underserved populations will be the most impacted by this decision

July 21, 2022

WASHINGTON (July 21, 2022) - A new report released today by Geiger Gibson Program in Community Health at the George Washington University Milken Institute School of Public Health examines the implications of Dobbs v Jackson Women’s Health Organization for the nation’s community health centers. Specifically, the report focuses on health centers’ capacity to mount a robust response to the expected surge in unanticipated pregnancies and the ensuing need for maternal and infant health care.  These challenges will be especially acute in the 26 states that either have abortion trigger bans in effect or are likely to adopt them. The report was authored by the Program’s Geiger Gibson/RCHN Community Health Foundation Research Collaborative.

Community health centers provide many essential safety nets and preventive health care services for underserved populations. Federal data shows that in 2020, health centers nationwide cared for 1 in 10 low-income births nationwide.  In the 26 trigger and likely-to-ban states, 72% of the health center patients who gave birth were people of color and 21% were Black mothers who already face disproportionate risks for maternal mortality.  More than 3 million women of reproductive age, 274,000 infants, and 156,000 children with developmental conditions received care at a community health center in one of the 26 trigger and likely-to-ban states. The analysis finds such critical maternity and infant care staffing shortages, that in none of the 26 trigger and likely-to-ban states are health centers able to meet basic maternity staffing ratios of 1 clinician for every 1,500 patients.

The report provides details of the severe staffing shortages community health centers face and focuses on the critical situation the ruling will create in Dobbs’ wake:

  • In 9 states (AL, AR, ID, MT, NE, ND, SD, UT, WY) all health centers, taken together, report fewer than 5 full-time equivalent OB/GYN physicians.
  • In 11 states (AL, AR, ID, LA, MS, MO, MT, ND, SD, UT, WY), all health centers, taken together, have fewer than 3 full-time equivalent certified nurse midwives.

“Community health centers provide critical health care services to our nation’s historically underserved populations,” Peter Shin, Associate Professor of Health Policy and Management at the GW Milken Institute of Public Health and lead study author, said. “This decision will have a disproportionate impact on low-income populations and communities of color, where maternal, infant and pregnancy-related health risks are already concentrated.”

Sara Rosenbaum, Harold and Jane Hirsh Professor of Health Law and Policy and a study coauthor added, “This is only one of Dobbs’ many fallout implications for the nation’s poorest and most underserved populations, who are caught in the decision’s crosshairs.  Our findings underscore the need for supplemental grant funding for health centers and the National Health Service Corps, whose clinicians form health centers’ staffing backbone.”

The report’s findings point to the need for supplemental federal funding support this year to enable health centers to mount an effective response and build the capacity to provide more maternity care and family planning services.  It also stresses the importance of ensuring that health centers are familiar with the full scope of hospitals’ emergency care obligations under the Emergency Medical Treatment and Labor Act (EMTALA).

The report, “In the Wake of Dobbs, are Community Health Centers Prepared to Respond to Rising Maternal And Infant Care Needs?” can be accessed here.




About the RCHN Community Health Foundation: The RCHN Community Health Foundation is a not-for-profit foundation established to support community health centers through strategic investment, outreach, education, and cutting-edge health policy research. The only foundation in the U.S. dedicated solely to community health centers, RCHN CHF builds on a long-standing commitment to providing accessible, high-quality, community-based healthcare services for underserved and medically vulnerable populations. The Foundation’s gift to the Geiger Gibson program supports health center research and scholarship.

About Milken Institute School of Public Health at the George Washington University:

Established in July 1997 as the School of Public Health and Health Services, Milken Institute School of Public Health is the only school of public health in the nation’s capital. Today, more than 1,900 students from 54 U.S. states and territories and more than 50 countries pursue undergraduate, graduate and doctoral-level degrees in public health. The school also offers an online Master of Public Health, MPH@GW, and an online Executive Master of Health Administration, MHA@GW, which allow students to pursue their degree from anywhere in the world.