Pharmacists Need Training and Legislative Support to Address Lack of Maternal Health Services

Community pharmacies could be a lifeline for women in maternal health deserts, but only if pharmacists get the training, confidence, and policy backing they need to step into that role, according to the Journal of the American Pharmacists Association.¹

“The US health care system suffers from a shortage of primary care providers, including obstetricians and gynecologists, and financial barriers to care,” wrote the authors of a study published in Pharmacy (Basel).² “It is estimated 11% of women in the US are uninsured, with millions more underinsured. Women may not be able to access routine, preventive health care services or may delay needed care.”

A recent cross-sectional study in South Carolina revealed that although community pharmacists in rural areas are the most accessible health care providers, they remain an underutilized resource in the fight against the national maternal health crisis. The research, which assessed both pharmacists and technicians, found that although there is a perceived need for services like contraception and postnatal care, significant knowledge gaps and operational barriers prevent widespread implementation.¹

This reality is particularly stark given that the US currently faces the highest maternal mortality rate of any high-income nation, with rates for Black women being 2.6 times higher than those for white women, according to the Journal of the American Board of Family Medicine.³

READ MORE: Federal Judge Temporarily Upholds Access to Abortion Medication

This crisis is fueled by the rapid expansion of maternity care deserts, defined as counties lacking hospitals with obstetric services, birth centers, or specialized providers. Currently, 36% of all US counties qualify as deserts, impacting 2.2 million women of childbearing age.

The situation is worsening as over 500 US hospitals have discontinued obstetric care since 2010, often due to financial pressures and staffing shortages. Rural women are disproportionately affected, being 60% more likely to die from pregnancy-related causes, often because they must travel more than 30 minutes to reach a facility.^3,4

The Pharmacist’s Barriers to Providing Maternal Care

According to the Pharmacy (Basel) study, pharmacists are uniquely positioned to bridge these gaps, as 96% of the population lives within 10 miles of a pharmacy. Patients visit their community pharmacist nearly double the amount they see a primary care physician, providing frequent opportunities for intervention.²

However, the current study identified pronounced knowledge gaps in hormonal contraception side effects, fertility care, and postnatal alarm symptoms like blood pressure changes.¹

Qualitative data from other regions echo these findings, with pharmacists reporting a reliance on self-education and outdated resources due to a lack of formal post-graduate training. In Ohio, research showed that only 35% of pharmacists were even aware they were practicing in a maternity care desert, and only 11% were familiar with the National Alliance of State Pharmacy Associations (NASPA) toolkit designed to support these roles.^5,6

Beyond clinical knowledge, pharmacists face significant systemic barriers, including a lack of time, insufficient staffing, and limited access to patients’ electronic health records. Without integrated records, it is difficult for pharmacists to coordinate care or identify potential medication exposures.^1,2

Furthermore, although 21 US jurisdictions now allow pharmacists to prescribe contraceptives, scope of practice remains highly fragmented by state lines. Legislative support is critical to standardizing these roles and ensuring that pharmacists can practice at the top of their education.^2,5,6

The Path Forward to Improving Maternal Health Care

Addressing these barriers requires more than just training. Most current insurance models do not adequately reimburse pharmacists for the cognitive services required for maternal health, such as screening for depression, intimate partner violence, or substance use.^1,2

Advocates suggest that liberalizing Medicaid policies to include pharmacist-led services and extending postpartum coverage could provide much-needed relief. By integrating pharmacists into the maternal health team through interdisciplinary collaboration and improved clinical support tools, the health care system can better support patients from preconception through the postpartum period.^1,3,5

Pharmacists represent a capable but untapped workforce that could serve as a vital gateway for those living in underserved, maternal-health-desert locales.²

“After addressing the knowledge barriers and boosting pharmacist confidence in providing services, rural states like South Carolina can focus on policy impact. Increasing maternal health care service points can boost maternal health outcomes in areas without other providers,” concluded the authors of the current study.¹ “Advocacy work, with a focus on growing pharmacist scope of practice, could lead to a growing number of maternal health access points and provide women in rural areas with stronger health care coverage across the maternal health spectrum.”

READ MORE: Women’s Health Resource Center

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REFERENCES

1. Davies A, Rudisell E, Ballou J, et al. Barriers, facilitators, and confidence to provide maternal health services in pharmacies in South Carolina. JAPhA. 2025;66(1):102996. https://doi.org/10.1016/j.japh.2025.102996

2. DiPietro Mager N, Bright D, Shipman AJ. Beyond contraception: pharmacist roles to support maternal health. Pharmacy (Basel). 2022 Nov 30;10(6):163. doi: 10.3390/pharmacy10060163.

3. Adashi EY, O'Mahony DP, Cohen IG. Maternity care deserts: key drivers of the national maternal health crisis. J Am Board Fam Med. 2025 May 12;38(1):165-167. doi: 10.3122/jabfm.2024.240198R1.

4. Seegert L. Maternity care crisis: more hospitals end deliveries. University of Penn Leonard Davis Institute for Health Economics. July 10, 2025. Accessed April 10, 2026. https://ldi.upenn.edu/our-work/research-updates/over-500-u-s-hospitals-have-stopped-delivering-babies-since-2010/

5. Alshehri FS, Alorfi NM, Ashour AM, et al. Pharmacists’ roles and perceptions in managing prenatal exposure to medications: a qualitative study. Medicine (Baltimore). 2025 Oct 31;104(44):e45618. doi: 10.1097/MD.0000000000045618.

6. Pharmacists can fill gaps in maternity care. Ohio Northern University. May 5, 2025. Accessed April 10, 2026. https://www.onu.edu/news/pharmacists-can-fill-gaps-maternity-care