County Health Profile

Improving maternal and infant health in Williamsburg County

Williamsburg County is one of only five South Carolina counties designated a maternity care desert. Following the December 2022 closure of its hospitals, the county's entirely rural delivery population faces significant barriers to care.

By working alongside local leaders, strengthening care coordination, and expanding community-based resources, we can support better health outcomes for mothers and infants in every ZIP code.

Key maternal and infant health outcomes

Williamsburg mothers and infants experience significant health challenges, particularly among Medicaid beneficiaries and Black mothers. Targeted efforts to improve prenatal care access are essential.

Preterm birth

18%

State average: 11.6%

Low birthweight

16%

State average: 9.5%

Inadequate prenatal care

22%

State average: 16.5%

Maternal vulnerability (MVI)

98.5

Exceptionally high risk

Access to care and key drivers

With the loss of obstetrics care in December 2022, delivery patients must now travel to regional facilities such as McLeod Regional Medical Center, MUSC Black River Medical Center, and Tidelands Georgetown. In 2024, 226 Williamsburg residents delivered, and 100% resided in rural areas (compared to 57% statewide).

What this means: Williamsburg residents do not have access to a hospital offering obstetric care within the county. Every delivery and perinatal emergency requires travel to a neighboring county.

Workforce shortage: The state faces a broader OBGYN shortage, with roughly a third of SC counties lacking a practicing OBGYN.
Demographics: High reliance on Medicaid (84% of deliveries) and 43% of the delivery population has a high school/GED education or less.
Health conditions: A high rate of physical health conditions (34%) among delivery patients, including hypertension and diabetes.

Understanding racial disparities and prenatal care timing

The majority of Williamsburg County’s delivery population identifies as non-Hispanic Black (63%). Structural barriers result in Black mothers in the county being nearly twice as likely as White mothers to not receive adequate prenatal care (29% compared to 17%). Those identifying as another race experienced an inadequate care rate of 50%.

Additionally, roughly 1 in 4 deliveries (26%) did not receive adequate prenatal care recently, an increasing trend from 22% in SFY 2022. This inadequate care is highly concentrated, with nearly 1 in 3 mothers lacking adequate care residing in the Hemingway and Kingstree zip codes.

Severe maternal morbidity (SMM)

Williamsburg County experiences an SMM rate of 195.3 per 10,000 deliveries.

Medicaid beneficiaries

89%

of SMM cases

Black mothers

88%

of SMM cases

Mothers with 3 or more prior births were far more likely to have inadequate prenatal care (42%) than first-time mothers (25%).

Policy recommendations for Williamsburg County

Addressing these challenges requires coordinated efforts across healthcare systems, community organizations, and public health agencies. Based on findings, we identify the following priorities to improve access and strengthen care continuity.

Expand integrated prenatal care systems

Expand access through telehealth, mobile clinics, and community prenatal navigation. With no county facility to anchor a traditional model, targeted mobile/telehealth outreach in Hemingway and Kingstree zip codes will have significant impact.

Maternal health workforce expansion

Support recruitment and retention through loan repayment and expanded use of certified nurse midwives. Establish formal agreements with regional hospitals (McLeod, MUSC Black River, Tidelands) for provider collaboration and telehealth.

Targeted racial equity in birth outcomes

Expand culturally responsive maternal health programs and home visiting services for high-risk pregnancies to address disparities, specifically supporting non-Hispanic Black mothers who comprise 63% of the delivery population.

Improve care access and coordination

Expand non-emergency medical transportation and community health worker support. Approximately 3 in 4 mothers had a perinatal ED visit. Coordination of transportation and childcare resources can reduce missed prenatal visits.

Strengthen chronic disease care bundles

Implement hypertension care bundles and coordinate diabetes management in pregnancy alongside the SC Maternal Health Innovation Collaborative. Over 1 in 3 mothers with perinatal ED visits had a hypertension diagnosis.

Teen pregnancy prevention strategy

Continue expanding sexual health education and reproductive healthcare access for adolescents. Prevention efforts among youth help reduce unintended pregnancies and improve long-term maternal and infant health outcomes.

Regional and state comparison data

Indicator	South Carolina	Williamsburg	Barnwell	Chester	Chesterfield	Marion	Orangeburg
Total deliveries	48,767	256	167	200	339	271	700
Infant Mortality Rate (per 1,000)	7.0	10.9	5.0-7.8	11.3	8.8	13.8	13.9-15.0
Preterm Birth (%)	11.6	15.6	9	8.5	13.9	15.1	13.7
Low Birth Weight (%)	9.5	16.0	8.4	10.0	14.5	12.9	13.4
Severe Maternal Morbidity (per 10k)	85.9	195.3	—	150	118	184.5	128.6
Inadequate Prenatal Care (%)	16.5	22.0	19.4	14	19.3	20.9	20.1
OB/GYN Provider Access	—	Maternity Care Desert	Maternity Care Desert	Maternity Care Desert	Low Access	Full Access	Low Access
Medicaid-funded births (%)	61.4	84.0	88	80.5	82.9	86.3	84.4
Maternal Vulnerability Index (MVI)	—	98.5	97.3	85.6	97.7	94.5	88.0

Selected Sources:

SC Dept. of Public Health, Infant Mortality and Selected Birth Characteristics (2023).

Institute for Families in Society, University of South Carolina (May 2025). Maternal deliveries snapshot, prenatal care adequacy and perinatal ED use in Williamsburg County.

March of Dimes, Perinatal Data Center (2025). PeriStats: South Carolina data.

Surgo Ventures: U.S. Maternal Vulnerability Index.