The United Health Foundation’s annual Health of Women and Children Report has ranked Tennessee as the 43rd healthiest state for 2024. The report evaluated various factors affecting health outcomes, including dental care access, firearm deaths, and sleep insufficiency. Of particular concern is the state’s maternal health landscape, with organizations highlighting poor outcomes for mothers and children. Three key issues contribute to these outcomes: availability of maternal care, unintended pregnancy rates (including among teens), and drug overdoses during pregnancy.
Prenatal care is crucial for both mother and baby. In Tennessee, over 8% of pregnant women either skip prenatal care or begin it late in their pregnancy. This issue is primarily due to a lack of supply; more than half of rural hospitals do not offer obstetric services, and nearly half of the counties lack OB-GYNs. Additionally, almost a third of Tennessee counties are considered “maternal care deserts.” A decline in obstetric residency applications by 21% since the state’s abortion ban in 2022 further exacerbates this issue.
Tennessee’s teen birth rate remains significantly above the national average despite an overall decline. The state’s teen pregnancy rate ranks 40th nationwide, with over 5,600 teens becoming pregnant in 2019. Unintended pregnancies also remain high at over 35%, with less than half of women using contraceptives before pregnancy.
The overdose crisis is another factor impacting maternal health in Tennessee. Overdose-related deaths nearly doubled from 2020 to 2022, with opioids being the primary cause. Pregnant women face challenges accessing harm reduction services due to limited availability and geographic concentration near cities.
Efforts are underway to address these issues. Steps include boosting the reproductive healthcare workforce by changing residency requirements for immigrating physicians and enhancing OB-GYN residency programs. Telehealth reforms could improve healthcare access by allowing out-of-state physicians to provide services without duplicative licensure requirements.
Additionally, expanding the scope of practice for non-physician healthcare providers could alleviate provider shortages. A new law effective July 2025 aims to increase buprenorphine-prescribing privileges for non-physicians.
Contraceptive access has been codified into state law in a measure passed in 2025 to protect against potential restrictions. However, future legislation could still limit access through age restrictions or reduced funding.
The newly formed Tennessee Maternal Health Equity Advisory Committee will focus on addressing disparities in maternal health across different demographics and regions within the state.
Finally, increasing opioid treatment program (OTP) availability is essential for women with opioid use disorder (OUD). Methadone and buprenorphine are recommended treatments that reduce overdose risk but require daily clinic visits under current regulations—a challenge given their limited number and distribution across Tennessee.
