By Brie Hunt
Senior Director of Policy Initiatives at South Carolina Institute of Medicine & Public Health
This spring, the South Carolina Institute of Medicine and Public Health (IMPH) released its newest taskforce report exploring opportunities to improve maternal and infant health in rural South Carolina by increasing access to care.
The report provides an action plan with recommendations related to care delivery, the workforce needed to support moms and babies, training and education, and the nonmedical drivers of maternal and infant health.
According to the South Carolina Maternal Morbidity and Mortality Review Committeeโs 2025 Legislative Report, almost 90% of maternal deaths in South Carolina were found to be preventable in 2021 (the latest year their data is available).
In 2022, 2023, and 2024 South Carolina earned an F on its March of Dimes report card for its preterm birth rate.
These poor outcomes are costly for the state. According to the Institute for Families in Society at the University of South Carolina, the average hospital charge for deliveries involving severe maternal morbidity in South Carolina is $109,240 compared to $35,309 for normal deliveries.[1] Medicaid pays for 71% of rural deliveries and 60% of deliveries statewide.
Economists project estimated annual costs of maternal morbidity in South Carolina include the following:
- $16 million in Direct Medical Costs
- $106 million in Lost Workforce Productivity
- $3.8 million in increased Reliance on Public Assistance
- ~$357 million in Increased Medicaid costs, reliance on emergency services, and increased medical needs of children[2]
Given these factors, IMPH convened the Improving Maternal and Infant Health: Increasing Access to Care in Rural SC Taskforce, which consisted of experts from across South Carolina, including state agency leaders and those working in communities supporting moms and their babies.
โThe health concerns around mothers and babies in South Carolina are alarming, but a lot of the common issues we see are preventable,โ says Maya Pack, executive director of IMPH. โThis taskforce has spent months researching and discussing actionable solutions to better the health of mothers and infantsโand through collaboration and action, we know it can be done.โ
Specific recommendations include:
- Ensuring all women in South Carolinaโs rural communities have access to affordable and convenient prenatal and postpartum care within 30 miles of their home or place of work through mobile care units deployed to the most underserved areas of the state, capitalizing on recent advances in telehealth to increase remote monitoring and replicating successful group prenatal education.
- Expanding and empowering essential members of the prenatal and postpartum workforce who provide care to moms and infants in rural areas of South Carolina by promoting team-based care, innovation in reimbursement policy, and adequate pay.
- Addressing transportation challenges and barriers by implementing models that work for high-risk and high-need moms and babies and replicating them in rural areas across the state.
โThereโs a reason this report is focused on mothers and infants living in rural South Carolina,โ says Dr. Lisa Waddell, taskforce chair. โWomen in rural areas of the state often experience poor health outcomes due to the unique barriers they face when compared to their urban counterparts, including health care provider maldistribution across the state, labor and delivery unit and hospital closures in rural areas, transportation challenges, lack of insurance coverage, and lower household incomes, to name a few.โ
Read all 12 recommendations on page 2.
You can also read detailed recommendations, including action plans, timelines and supporting organizations beginning on page 43.
The South Carolina Institute of Medicine and Public Health (IMPH) is a nonpartisan, nonprofit organization working to collectively inform policy to improve health and health care in South Carolina.