A midwife crosses 'maternity deserts' to make a difference for Black moms and babies

A midwife crisscrosses Alabama to care for pregnant women and deliver babies. It's an important profession as maternity deserts expand across the U.S., according to the latest March of Dimes report. Maria Fabrizio/NPR hide caption

Nadia Gramby cherishes quiet moments with her baby girl River Emmanuel, who's starting to talk. They exchange snuggles and baby coos each morning.

"Did you sleep well last night?" Gramby asks her little girl, who has dark curls and a big smile.

Besides being a mother of two and a wife, Gramby spends her days and many nights as a midwife caring for other moms and babies across Alabama where she lives and practices.

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The kind of care Gramby offers is important because more than 52% of counties in the U.S. do not have hospital-based labor and delivery services, according to the latest March of Dimes "Nowhere to Go" report on maternity care deserts, out Tuesday. The 2026 report also finds one in three counties, or nearly 35%, are maternity care deserts, meaning they have no birthing facilities or obstetric clinicians.

Nadia Gramby spends her days and many nights as a midwife caring for other moms and babies across Alabama, where she lives and practices. Nadia Gramby hide caption

"This goes beyond a mere inconvenience," said Dr. Michael Warren, chief medical and health officer for the March of Dimes. "We know that those women who live in maternity care deserts are more likely to have bad outcomes when it comes to their pregnancies."