Executive summary

The Legislature directed the Office of Financial Management (OFM) to study services for pregnancy-related health care to include analyses of access to services and disparities, location, and type of provider and demographics of patients and providers (Chapter 376, Laws of 2024). See Appendix A for the full proviso language. This report presents OFM’s key findings on the volume and geographic distribution of birth facilities and obstetric care practitioners in Washington. This work builds on OFM’s 2024 report highlighting the declining birth rates and disparities in access to prenatal and postpartum care.

OFM’s main findings for this report include:

  • The majority of birthing centers and hospitals providing obstetric care are in western Washington, with King County having the highest percentage.
  • Hospitals with fewer than 500 births (low volume) per year make up the largest category of hospitals by birth volume each year.
  • While King County has the highest number of obstetric care practitioners, the counties with the highest rate of practitioners per 100,000 women of childbearing age fluctuated among small metro (Chelan County) and rural (Pend Oreille County) counties and may reflect issues with reporting of practitioner networks.
  • Non-Hispanic Black, American Indian/Alaska Native, Native Hawaiian and Pacific Islander, and Hispanic clinicians are severely underrepresented among clinicians providing obstetric services in Washington.

Recommendations

The Legislature instructed OFM to make recommendations regarding how to fill gaps in service as well as recommendations for future analysis. Based on these findings, OFM offers the following recommendations to improve access and outcomes of obstetrical care:

  1. Create a regional focus on maternal access to obstetric care to ensure access to a safe birthing experience
  2. Improve data access and collection to support policy planning and development
  3. Increase the supply and diversity of the state’s maternity care workforce
  4. Support women in their choice of birth setting by enhancing infrastructure and reducing barriers to accessing care

Downloads

Birth Volume and Maternal Health Workforce Supply in Washington State