There are different causes of stroke, but the most common is a blockage of blood flow to part of the brain, which is called an ischemic stroke. 

Transient ischemic attacks, or TIAs — sometimes also called mini-strokes — are also ischemic attacks, but they only last for a few minutes before blood flow is restored. 

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That doesn’t mean they’re any less serious than a full-fledged stroke, though, noted Dr. Karishma Patwa, a cardiologist with Manhattan Cardiology, which provides cardiac testing and preventive treatment in New York.

Patwa shared with Fox News Digital the most important things to know about identifying and preventing mini-strokes. 

"Every second that the brain goes without oxygen increases the likelihood of serious and permanent brain damage," Patwa said. 

"Just like a stroke, a TIA deprives the brain of oxygen and should be treated with the same urgency."

There are several possible causes of a TIA. 

A clot could form in the brain itself, or a clot from another part of the body can break loose and make its way through the bloodstream until it becomes lodged in the brain, Patwa said. 

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"In order to best treat a TIA and prevent a future stroke, doctors will want to determine the exact cause of the TIA," the doctor said. 

"The longer a person goes without examination, the less likely doctors will be able to determine the cause, leading to a diagnosis of cryptogenic TIA — which means TIA of unknown origin."

Once someone has had a mini-stroke, the risk of having another stroke event is between 5% and 10% within the first seven days, Patwa warned.

"This number actually goes up to about 15% in the first month after a TIA and up to 35% over the course of a patient’s lifetime," she said. "That’s why early recognition and treatment of a TIA is extremely important — to prevent the more devastating complications of a large stroke."

The symptoms of a TIA are the same as symptoms of stroke, Patwa noted. 

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The symptoms can include:

"Symptoms tend to appear suddenly and without any obvious cause," Patwa said. 

"In the case of a TIA, the symptoms will last for less than a day, and often just a matter of minutes or even seconds, but it should still be treated as a medical emergency."

It’s important to act quickly as soon as the symptoms begin, she said.

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"At that time, there’s no way to know whether an ischemic attack will be transient or not. Don’t wait to find out — call 911 immediately," she advised.

The doctor recommends using the FAST acronym, a common tool for remembering symptoms and action steps when someone is suspected of having a stroke or TIA.

"It’s important to stress that someone who just experienced a TIA should not get behind the wheel of a car," Patwa also said. 

"Calling 911 and requesting an ambulance would be the best course of action, and in lieu of that, the closest responsible adult should drive the person to the emergency room," she added.

For people who have had a TIA, prompt diagnosis and aggressive treatment are the best route to an improved outlook, Patwa said.

"People who delay or refuse examination and treatment are much more likely to experience a stroke during the next 90 days."

In most cases, a mini-stroke is diagnosed with a physical and neurological examination, medical history and imaging tests such as an MRI, CT scan or X-ray. 

"Depending on what is found during diagnosis, a treatment plan could include medication, the use of stents, angioplasty or surgical procedures," said Patwa. 

"There are also steps a person can take to help prevent a TIA, or to help prevent a stroke after having a TIA," said Patwa.

These preventative steps can include:

People who are at risk for stroke or coronary artery disease are at higher risk for transient ischemic attacks, Patwa said.

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"This includes the elderly, smokers and patients with diabetes, hypertension and high cholesterol," she noted. 

The highest risk factor for a TIA is a previous TIA or stroke, Patwa added.

"The most important thing is to not treat a TIA like a one-and-done anomaly," she said. 

"A TIA is a warning that a stroke is not only possible but likely, and in the near term."

She added, "Anyone suspected of experiencing a TIA should seek medical attention immediately."

For more Health articles, visit www.foxnews.com/health. 

A puppy recently tested positive for rabies and was euthanized in New Mexico, according to a news release from the state’s health department.

The animal, located in Bernalillo County, had shown signs that included tremors, lack of coordination and agitation. 

Health officials said the pup might have contracted the virus while in Texas, the news release stated.

Six people exposed to the puppy were treated with post-exposure rabies shots as a precautionary measure. This was New Mexico’s first canine rabies case in 10 years, according to the release.

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"Young puppies are especially vulnerable to various infectious diseases, including rabies, parvovirus and distemper, until they've completed their full vaccine series," said Erin Phipps, the state public health veterinarian, in the release. 

"It's worth noting that rabies has a prolonged incubation period, often lasting weeks or months from infection to symptom onset, and animals become contagious only after symptoms appear," she added.

The puppy had not yet received its rabies vaccine due to its young age, the release stated.

Several other rabies cases have recently been reported throughout the United States. 

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On Sept. 6, Caldwell County Animal Care Enforcement in North Carolina reported the county’s third case of rabies this year, after a bat that encountered dogs was sent to be tested by the North Carolina State Laboratory. 

On Sept. 11 in Wisconsin, the Racine County Public Health Division reported its second rabies case of this year after a bat tested positive for rabies.

In New York, the Dutchess County Department of Behavioral & Community Health warned residents about a rabid raccoon that was captured in Hopewell Junction in August.

Each year, nearly 60,000 people die from rabies around the world.

Approximately a quarter of those deaths reported in the U.S. resulted from dog bites that the victims sustained during international travel, the Centers for Disease Control and Prevention (CDC) stated on its website. 

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Rabies is a "100% preventable disease" through the vaccination of pets, the CDC said.

"The best way to prevent an outbreak of rabies is to vaccinate," noted Dr. Jeffrey Krasnoff, a veterinarian at Brookville Animal Clinic on Long Island, New York.

Rabies is a highly contagious virus that is transmitted through the saliva of infected animals through a bite, Krasnoff told Fox News Digital.

"The most obvious signs that an animal has rabies are aggressive behavior and excessive salivation," he said. "In wild animals, signs can include being out and about during the day, as well as exhibiting abnormal behavior, aggressive behavior and excessive salivation."

Rabies poses a threat not only to pets, but can also prove deadly in humans if not treated in a timely manner, health experts told Fox News Digital.

The virus can be transmitted to a human through a bite, or by the infected animal’s saliva getting into a person's eyes, nose, mouth or a break in the skin. 

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"Symptoms of rabies infection include fever, headaches, excessive salivation, muscle spasms, confusion and even paralysis," Dr. Fred Davis, associate chair of emergency medicine at Northwell Health on Long Island, New York, told Fox News Digital.

"The key is to seek treatment before such signs develop, as there is no specific treatment to stop the infection, and only vaccination can help prevent the infection from occurring," he added.

Typical treatment includes a series of rabies shots.

Anyone who has been in contact with the saliva of such animals as dogs, bats, coyotes, foxes, skunks or raccoons — especially if the encounter occurred during the day, when most of these animals are nocturnal, or if the animal in question is acting erratic — should seek immediate emergency treatment, Davis said.

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Krasnoff explained that when an animal bites a human, it is recommended that the veterinarian call the state’s Department of Health for instructions, which may include a 10-day quarantine and testing of the animal. 

It is also important for pet owners to check with their vet to ensure that the animal is up-to-date with rabies vaccinations.

Health agencies said that if an animal tests positive for rabies, it is usually euthanized.

"Due to rabies being so contagious to animals and humans, the course of action is euthanasia of a suspected rabid animal," Krasnoff told Fox News Digital.

Currently, the World Health Organization (WHO) is working on a collaborative global effort called Zero by 30, with the goal of eliminating dog-mediated human rabies deaths by 2030. 

The agency designated Sept. 28 as World Rabies Day to help raise awareness of how to prevent rabies and to help ensure that post-exposure prophylaxis (preventive medical treatment) is available to everyone.

"The world has the vaccines, medicines, tools and technologies to break the cycle of one of the oldest diseases," WHO says on its website. 

"Together in unity, we can eliminate rabies, leaving no one behind."

For more Health articles, visit www.foxnews.com/health.

Prostate cancer is a disease found in men that develops in the prostate gland. 

One in eight men will be diagnosed with prostate cancer in their lifetime, according to the American Cancer Society (ACS), with older men more likely to develop the disease. 

Prostate cancer is second only to skin cancer as the most common cancer diagnosed in men, according to the source. 

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Symptoms of prostate cancer are typically very minimal, or not experienced at all. 

Below is all you need to know about prostate cancer.

Any type of cancer starts when cells grow out of control in certain parts of the body. 

Nearly every part of the body can be affected by cancerous cells, and they can then spread to other areas. 

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Prostate cancer is a type of cancer found in men that begins in the prostate gland and can then grow beyond that in more severe cases. 

"The most common symptom is no symptom at all," Dr. Christopher Anderson, a urologist with New York-Presbyterian/Columbia University Irving Medical Center, previously told Fox News Digital in 2017.

Some men may experience symptoms such as pain in their bones and weight loss when the cancer has already spread, Anderson said.

Dr. Philip Kantoff, a medical oncologist and chair of the department of medicine at Memorial Sloan Kettering Cancer Center, reiterated that the disease does not typically cause symptoms. 

Symptoms could instead be due to an enlarged or inflamed prostate, neither of which are cancerous.

Dr. Ketan Badani, vice chairman of urology at Mount Sinai Health System, said that "some patients may have vague urinary complaints," like having to urinate more frequently, and that there are no symptoms until the disease is advanced. 

The majority of men who have urinary issues do not have prostate cancer, he noted.

Men ages 60 to 74 are considered more at risk, according to the Surveillance, Epidemiology and End Results (SEER) program. 

Family history, "especially a first-degree relative like a father or brother" who has been diagnosed, is another concern, Badani added.

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African, Afro-Caribbean, South Asian and Hispanic men are more at risk for "more aggressive" forms of prostate cancer, he said.

For men of African descent, there is an increased risk of both prostate cancer diagnosis and dying from prostate cancer, Anderson said.

There are several lifestyle changes men can implement into their lives to potentially reduce their risk of prostate cancer. This includes maintaining a healthy weight, staying active and having a healthy diet, according to the ACS, such as one including very little red and processed meat and processed foods, but filled with lots of fruits, vegetables and whole grains. 

Most commonly, prostate cancer is adenocarcinomas, meaning it develops in the gland cells, according to ACS.

There are other types of prostate cancer, according to the source, but these are rare. 

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Other types are small cell carcinoma, neuroendocrine tumors, transitional cell carcinomas and sarcomas.

In general, prostate cancer grows very slowly. 

Many people who have it die from other causes without ever knowing that they had the cancer, according to the ACS.

Prostate cancer is curable, so long as it's diagnosed early enough, according to Mayo Clinic.

Treatment options will depend on the stage of the cancer and the overall health of the individual. For early prostate cancer, immediate treatment may not be needed, per the source. 

More severe cases of cancer are usually treated through radiation or surgery.

"A discussion with your physician is warranted before symptoms occur," Kantoff advised, adding that men should decide with their doctors if a prostate-specific antigen (PSA) test, which looks at the level of PSA in blood, is right for them.

For more Health articles, visit www.foxnews.com/health

Badani recommended that men receive both annual digital rectal exams and PSA tests. Multiple PSA tests over time are a better indicator of potential concerns as opposed to a single test result, he explained.

If you are concerned you might have prostate cancer, speak to an internal medicine doctor or a urologist, Anderson recommended. He stressed that all patients with blood in their urine should see a urologist.

PSA screening has been a controversial topic in the past. In 2012, the U.S. Preventative Services Task Force recommended against PSA screening when it said "there is moderate certainty that the benefits of PSA-based screening for prostate cancer do not outweigh the harms." 

In 2018, the task force said in its final recommendation that men ages 55 to 69 should discuss potential benefits and negatives of a PSA screening with their physician before undergoing the test. 

While a PSA screening has the potential to reduce the risk of death, negatives listed by the task force include "false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and erectile dysfunction."

They do not recommend PSA screening in men ages 70 and above.

"Proper use of PSA is what I recommend from an early detection standpoint," Kantoff said.

Symptoms should not be the motivating factor for screening, he said, saying it should instead be a decision in one’s 40s about whether PSA testing should be done. He recommended that those with a family history or people of African American descent think about early detection.

An analysis of previous clinical trials published in 2017 said screening lessened the risk of dying from prostate cancer by 25 to 32% compared to men who did not get screened, a summary for patients explains online. 

The Associated Press contributed reporting, as did Andy Sahadeo and Zoe Szathmary. 

By Anesta Henry

Style met substance on Friday, as young males and the young at heart descended on the corner of Villa Road and Warner’s Road, Brittons Hill, for a fresh haircut and a healthy perspective on life. 

Amid the celebration of style and camaraderie, there was a poignant reminder of the ongoing prevalence of HIV/AIDS in society.

Minister of People Empowerment and Elder Affairs Kirk Humphrey, took centre stage at the annual “Man Aware (Free Haircuts)” event. With his own close-cropped coiffure setting the tone, made an impassioned appeal to citizens to embrace safe sexual practices as a way of life. As he stood at a popular community junction, his message echoed: “HIV is still very real. It is still very prevalent.”

The event attracted children to get a fresh trim for back to school. But beyond the cool haircuts, it was a chance to interact with professionals who shared age-appropriate information about HIV/AIDS. It was a unique opportunity for the younger generation to learn about responsible living in a fun and engaging way.

While the Ministry of Health and Wellness is yet to reveal the latest statistics on Barbados’ HIV/AIDS prevalence, Humphrey said the Ministry of People Empowerment was playing its role as it relates to educating Barbadians about the importance of engaging in healthy sexual practices.

He said: “The numbers we have are from 2020. But I do think that regardless of the numbers, the truth is that it is clear to me that we have to be able to engage in sexual practices that are healthy.

“I think that a lot of people think that HIV is no longer there, and a lot of people are behaving as if HIV is no longer real. In many cases, because of the medication that you now have, it has gone from being a life-depriving illness to almost a chronic illness; it is still very prevalent.”

Encouraging Barbadians to get tested to know their HIV/AIDS status,  Humphrey suggested that a person who knows they have a clean bill of health would refrain from engaging in unhealthy sexual practices.

People who have tested positive for HIV/AIDS would be aware that they must make the move to access medication, he added.

The Man Aware event went beyond haircuts by offering health check-ups, including blood pressure and sugar level assessments, in partnership with the Livewell Clinic. Humphrey highlighted the significance of these tests, emphasising that early detection can prevent life-altering non-communicable diseases.

“We are also working with the Livewell Clinic to be able to do health checks so that people can get their blood pressure checks and their sugar level checks to see if they are pre-diabetic or diabetic. This health check is one of the things that I think is going to be very important for the ministry.

“I think it is very important because a number of Barbadians are dealing with non-communicable issues, some of them becoming life-depriving in circumstances where they could be avoided if we get early testing and if we continue to do the things we are supposed to do, like eat right and make healthy choices. So, I want to thank the HIV/AIDS Commission for this work. I want to thank them for their constant advocacy, but I also feel like the time has come for Barbadians to recognise that the health choices we make in terms of what we eat also have consequences.”

The “Man Aware (Free Haircuts)” event, a blend of fashion and substance, continues to make its mark – one stylish haircut at a time – on Saturday at the Child Care Board, Cheapside, The City. 

anestahenry@barbadostoday.bb

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Black Knight Bikers and other bikers in Barbados joined forces on the weekend to assist Joann Hall, a social worker at the Ministry of Education, as she continues her battle with rheumatoid arthritis which has already caused her to have knee replacement and be under medication for pain relief.

The group of bikers joined a charity walk that began at Esso in Paynes Bay, St James and ended at Folkestone Marine Park in the same parish, where they socialised with other people who walked in honour of Hall.

She has dedicated 20-plus years of her life to ensuring that children under her charge receive the best level of education possible.

President of the Black Knight Bikers Fabian Reeves said club members were pleased to lend support to the initiative, noting that when Hall was fully on her feet, she worked with various agencies to get financial support and placement for children at schools that cater to their learning styles, and advocated for abused and underprivileged students.

“When we heard of this walk, we immediately said this is something we need to affiliate ourselves with since we value the work of people in the education system who advocate for children who are abused, especially if they are bullied,” Reeves said.

Vice president of the bikers group, Kevin Wickham echoed those sentiments and said he wanted to see more charities give back to causes like this.

In accepting the monetary donation from the bikers, Hall said because the condition has now affected her hip, she needs to raise as much money as she can to assist with surgery. Her initial target is $50 000. (PR)

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Caribbean Wellness Day 2023 will be commemorated with a month-long celebration under the overall theme for the 5 year period, “Power Through Collective Action”

View the full post Caribbean Wellness Day 2023 on NOW Grenada.

The Carriacou workshop is part of a series of parish-level trainings to strengthen the multi-sectoral teams for gender-based violence

View the full post Gender-Based Violence workshop held in Carriacou on NOW Grenada.

View the full post Holistic elder care on sister isles being looked at on NOW Grenada.

When it comes to cancer treatments, most people are familiar with chemotherapy, radiation and surgery. 

Yet there is another emerging, lesser-known therapy that is showing promising results in treating blood cancers.

With CAR T-cell therapy, the patient’s T-cells are taken from the blood, engineered to attack cancer cells and then infused back into the patient’s body through an IV, Dr. Noopur Raje told Fox News Digital.

Raje is the director of Multiple Myeloma at Mass General Cancer Center, which is a member of the Mass General Brigham system. Mass General Brigham has a Gene and Cell Therapy Institute that helps advance gene and cell therapies like CAR-T.

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"I think it's made a big change in people's lives and how we take care of people," she told Fox News Digital in an interview. 

"It's one of the most personalized ways of taking care of some of the blood-related cancers."

At Mass General, Raje and her team treat patients with multiple myeloma, a rare form of blood cancer that attacks the plasma cells. 

Most of their patients are between 60 and 70 years old, she said.

CAR stands for chimeric antigen receptors, which are proteins that enable T-cells to target the tumor antigens produced by cancer cells.

T-cells are a type of white blood cell that helps to fight germs and prevent disease, per the Cleveland Clinic.

There are currently six CAR T-cell therapies that are FDA-approved to treat leukemia, lymphomas, multiple myeloma and other blood cancers.

"We are taking our patients’ T-cells, which are the immune cells, and then activating them and putting a chimeric antigen receptor (CAR), which can recognize a protein on a cancer tumor," Raje said.

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Because Raje treats multiple myeloma, her team started off by doing studies against a protein called BCMA, which is found in cancerous plasma cells.

The re-engineered T-cells continue multiplying in the body, so they can seek out and kill more tumor cells, the doctor said.

"We are seeing extremely high response rates, between 82% and 100%," she told Fox News Digital. "Now we need to do a better job of maintaining that response."

Before CAR T-cell therapy, Raje said, patients were started on a treatment and then stayed on it for an indefinite length of time.

"This is the first time that patients are getting a ‘one-off’ treatment, and then we're just watching them with no more treatment at all," she said.

While the treatment can be a little "involved" at the beginning, Raje said, once it’s complete the patient receives no new therapies for up to three years.

"And I have some patients who are on no treatment for way longer than that, which is a big advancement," she added.

"Obviously, we need to do better — we need to cure people," Raje said. 

"We're not quite there, but the next step is to start the treatment earlier, so we can start seeing more control of the disease over a longer period of time."

As of now, the FDA has approved CAR T-cell therapy as a "last resort" when the disease has persisted through all other available treatments; but Raje hopes that soon, it will be available to patients earlier in the course of their cancers.

CAR T-cell therapy is expensive — costing anywhere from $500,000 to $1,000,000, per WebMD. Raje pointed out, however, that many insurance plans cover at least some of the cost. It is also covered by Medicare.

"I think one has to start looking at the time saved in terms of quality of life in not coming back to the hospital and not being on any other meds," she said.

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There is some risk of side effects for those receiving CAR T-cell therapy, primarily a condition called cytokine release syndrome (CRS). It can occur when the immune system responds too aggressively to infection.

"When the CAR T-cell kills the tumor, it produces a bunch of proteins, and when it does that, it can make you quite sick," Raje said.

"But as we've used more and more of these therapies, we've gotten pretty good at managing this, and we have the antidotes for these kinds of toxicities," she added.

Another potential side effect is a condition called ICANS, or immune effector-mediated neurotoxicity. 

"With this, people can get confused, sometimes to the extent that they can actually go into a deep coma," Raje said. "It's important to recognize and treat these conditions earlier."

Sandy Caterine, a retired accountant who lives in Rye, New Hampshire, was part of a clinical trial for CAR T-cell therapy. 

She was diagnosed with multiple myeloma in August 2019. 

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"It kind of came out of nowhere," Caterine told Fox News Digital. "In retrospect, maybe I had a couple of little symptoms."

Caterine had experienced some back pain, fatigue and nausea, but initially chalked it up to dehydration. 

When the symptoms didn’t go away on their own, she saw her primary care physician and got some blood tests, which led to her diagnosis.

"I had never even heard of multiple myeloma," Caterine said. "All I heard was that it was incurable and no one could predict what the life expectancy might be."

For several months, Caterine was on a regimen of numerous drugs, infusions and radiation, none of which fully resolved her cancer. Then she learned about the clinical trial for CAR T-cell therapy.

"Sandy has what is known as high-risk disease, based on the genetics of the cancer," said Raje. "This usually doesn’t have good outcomes, but Sandy had a great response to the trial."

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Caterine, who is 62, did experience the CRS illness as a side effect, which caused her to endure nausea, fatigue, fever and disorientation. 

She remained in the hospital for 15 days.

"It took me a while to get my strength back," she said. "I do remember them taking very good care of me."

Caterine has gotten periodic bone marrow scans every three months since her infusion.

"So far, there has been no sign of the disease," she said. 

"Dr. Raje told me the hope was that it would work for two to three years, and I am already over two years."

Caterine’s experience has helped her appreciate each day more than she did before, she told Fox News Digital.

"These are two years that I never thought I would get when I was first diagnosed," she said. 

"It's just great that I can continue to live my life and be with my family."

CAR T-cell therapy started out for use in leukemia, later branching out to other blood cancers like lymphoma and multiple myeloma. 

Raje is hopeful that the treatment eventually will become available for other types of cancers, including cancers of the breast, colon and brain.

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"We have an ongoing study where we are looking at CAR T-cell therapy in glioblastoma, a type of brain cancer, which we would have never thought of doing early on," she said. 

"And we have a whole host of new CARs coming down the pike against different antigens."

The doctor emphasized the significance of teaching the body’s own immune cells to fight against cancer cells.

"In my mind, it's probably the most personalized way of being able to take care of your own disease, which is amazing," she said.

For more than five million women in the U.S., getting maternity care is difficult or impossible.

More than one-third (36%) of U.S. counties are considered "maternity care deserts," which means they do not have any obstetric providers or birth centers.

In just one year, the number of birthing hospitals has decreased by 4%. Since 2018, a total of 301 birthing units have closed.

These are some of the key findings from the March of Dimes’ latest report, "Where You Live Matters: Maternity Care Deserts and the Crisis of Access and Equity," which explores the state of maternity care throughout all 50 states, Washington, D.C., and Puerto Rico.

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A nonprofit organization based in Arlington County, Virginia, the ​​March of Dimes aims to improve the health of mothers and babies. 

This is the sixth iteration of the maternity report, but it’s the first one to break down the numbers by state and county.

"In the report, we’re looking at every aspect of these maternity care deserts, from miles being driven to chronic conditions, as well as socioeconomic and racial backgrounds," explained Dr. Elizabeth Cherot, the newly appointed CEO of March of Dimes in New York City, in an interview with Fox News Digital.

As more units and providers are closing, the number of maternity deserts is on the rise, putting women and babies at risk, warned Cherot, who was an OB/GYN for 30 years.

Dr. Suzy Lipinski, a board-certified OB/GYN at Pediatrix Medical Group in Denver, Colorado, has seen firsthand the impact of what she calls a "maldistribution of care."

Where Lipinski practices in Denver, there are six to seven hospitals that offer obstetric care and high-risk specialty care within 30 minutes between each facility — but some are receiving patients who are transported from the rest of Colorado and surrounding states.

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"In the entire state of Wyoming, there is not a hospital with a dedicated high-risk OB team or neonatal intensive care unit to take care of preterm infants," Lipinski said. 

"The high-risk patients are transferred, often by helicopter or plane, to Denver and Salt Lake City."

She added, "As I meet these patients, they tell me they drove over an hour to get to the hospital they were transferred from — and now they are getting care six to eight hours away from home, without family support and potentially without the ability to keep their job."

In Colorado, many of the mountain towns do not have maternity units, so patients must travel 60 to 100 miles over mountain passes — which may close during snowstorms — to get to the closest hospital, Lipinski said.

Before coming to Denver, she trained and then practiced for 10 years in Iowa, where about 70% of rural obstetrics units have closed since the late 1990s. 

Many of her patients drove 100 miles to get specialty care — or were brought in by ambulance after delivering their babies in their cars while trying to get to the hospital.

A pregnant woman who lives in a maternity desert will have to drive to the next county that has available care. For the lucky ones, that might mean crossing a nearby county line — but for others, it could require hours of driving, which could be dangerous during active labor or a medical emergency.

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"Women will do anything they can to overcome these barriers," Lipinski said. "I cannot begin to name all the ways they struggle to get the care they need."

Some women choose to limit the care they get, perhaps only attending half of the recommended prenatal visits, for example. 

Others might choose to live with a family member who is closer to a maternity care provider, so they know they can get to the hospital in time, Lipinski said. 

"Some will seek out community midwives who aren’t licensed and do not have consistent training," she said. "Or they might go to their closest ER when they think something is wrong, but never have consistent care from a regular provider."

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More dangerous still, some women are bypassing prenatal care. 

"Women who don't get prenatal care are three times more likely to have a worse outcome," Cherot said.

Some women go into labor while trying to reach a hospital.

"It’s not uncommon for me to get a call that the mom just delivered at the gas station, and then I just wait for them at the emergency department," Dr. Kristy Acosta, a family medicine/OB provider at Brownfield Regional Medical Center in Texas, told March of Dimes.

Kali Bautista, who lives in Terry County, Texas, gave birth while living in a maternity desert in Texas. Her hometown is 30 to 45 minutes away from the city of Lubbock.

"One of my biggest fears and concerns was what if I deliver on the way there, and not knowing what to do," she told March of Dimes. 

"Living in rural areas, there’s a lack of resources in general. There’s a lot of poverty here."

The states with the highest rates of maternity care deserts include North Dakota, South Dakota, Alaska, Oklahoma and Nebraska, which are all states with more rural populations, according to the March of Dimes report.

In North Dakota, 71.3% of rural residents live at least 30 minutes from a maternity care hospital, with an average distance away of 54.7 miles, Cherot said.

In terms of quality of care, New Mexico has the highest rate of inadequate prenatal care — closely followed by Hawaii.

There is a racial and socioeconomic component as well, Cherot said, with Black and Native American women experiencing the worst outcomes and the highest rate of inadequate prenatal care.

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Many factors contribute to the closure of a hospital or maternity unit, with staffing-related struggles topping the list.

Obstetricians have been shown to have one of the highest burnout rates in health care, according to the March of Dimes press release — which makes it harder to attract and keep staff.

"We need more trained obstetricians," Lipinski said. "There is a shortage in the U.S., and as many [doctors] are in their 50s and 60s, there will be a large wave of retirements in the coming years, and there are not enough new OBs coming out of training to replace them."

Midwives can provide support, she noted — but they don’t perform any of the surgical procedures, such as Cesarean sections, operative vaginal deliveries, cervical cerclage (stitches to prevent a preterm birth), turning a breech baby or any of the procedural elements of obstetrics care.

Low birth volumes, rising costs and lack of financial reimbursement also contribute to the problem, per the March of Dimes report.

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More than half of the births in maternity care deserts are reimbursed by Medicaid, according to the American Hospital Association. 

This means the hospitals have lower reimbursement rates, which can cause them to actually lose money by providing obstetrics care.

"It all goes back to economics," Cherot said. "We're not prioritizing moms and babies, even though they’re the entry point for all of health care."

She added, "We are not prioritizing families and that first year of life and all the support that moms need. 

The complicated issue of maternity deserts requires a "multi-layered approach," Cherot said. "If there was one clear solution, we would have done it already."

The March of Dimes has several programs in place that aim to improve the availability and quality of maternity care.

These include working to expand postpartum care in the Medicaid space, bringing mobile care units into high-risk areas to provide prenatal visits and offering a range of support mechanisms for families, Cherot said.

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Additionally, the March of Dimes is helping to find, train and provide doulas — trained childbirth professionals who help patients during and after delivery.

The organization is also funding Prematurity Research Centers (PRCs) to assist with the care of premature babies. 

Through its Innovation Fund, the March of Dimes also invests in early-stage companies that aim to overcome maternal and infant health challenges.

"We need more support for rural hospitals in maternity care deserts to reopen units to provide care," Lipinski said. 

"This requires systems that are designed to provide these hospitals with support. To provide care, they may need to partner with specialty doctors who will either come do satellite clinics or arrange transport to the higher levels of care."

Added Cherot, "Every baby deserves the healthiest start to life, and every family should expect equitable, available, quality maternal care."

She added, "These new reports show that the system is failing families today, but it paints a clear picture of the unique challenges facing mothers and babies at the local level — the first step in our work to put solutions in place and build a better future for all families."