Postoperative Care and Management in Pediatric Hematology-Oncology Patients.

Access to high‐quality perinatal health care is crucial for healthy birth outcomes, yet this is not the reality for numerous women in the United States. In 2024, approximately 5.5 million women in the United States lived in counties with limited or no access to quality perinatal health care. The situation is critical in rural southern states like Alabama, where significant perinatal inequities have existed for decades and continue to result in a decline in access to services. The number of rural counties in Alabama without active labor and delivery units continues to climb. Currently, only 15 of 55 rural Alabama counties have hospitals providing birthing services, leaving women without access to skilled health care providers and needing to travel long distances for perinatal care, important determinants of maternal and infant outcomes., According to the March of Dimes 2025 report, 19.3% of Alabama women received inadequate prenatal care. Improving the health and well‐being of women, infants, and children remains an important public health goal. Despite this, maternal and infant mortality and pregnancy‐related complications remain significant concerns nationally and in Alabama. The state consistently ranks among the worst in the United States for maternal and infant health outcomes. Despite a recognized need for change and efforts to bridge care gaps, the March of Dimes again awarded Alabama a grade of “F” on its 2025 Report Card. Alabama has the fourth‐highest preterm birth rate (12.7%), and with an infant mortality rate of 7.6 infant deaths per 1,000 births, Alabama is 1 of 8 states with the highest infant mortality rate among all 50 states. These statistics are even worse for Black women and infants in Alabama, with the March of Dimes reporting a Black preterm birth rate of 17.0% and a Black infant mortality rate of 12.1 in its 2025 Report Card. Preterm birth and its complications are a leading cause of infant mortality in the first year, second only to congenital disabilities. Maternal mortality (deaths while pregnant or within 42 days of when the pregnancy ends) increased significantly during the COVID‐19 pandemic, but by 2023, the US ratio of 18.7 maternal deaths per 100,000 live births had almost returned to prepandemic levels. However, states in the south, including Alabama, continue to report significantly higher maternal mortality ratios, likely due in part to the lack of Medicaid expansion and the many rural areas impacted by hospital obstetric unit closures and maternity care deserts. Alabama has the nation's sixth‐highest maternal mortality ratio at 35.1, and 34.3% of its counties qualify as maternity care deserts., Again, racial and ethnic disparities exist across maternal health outcomes. The state's Maternal Mortality Review Committee, established in 2018, reported a maternal mortality ratio for Black, non‐Hispanic women of 77.0 and found preexisting chronic conditions such as cardiovascular‐related events, as well as substance use, infections, and hemorrhage, to be the leading causes of maternal death.