Late last week, a working group commissioned by Governor Sarah Huckabee Sanders released their first report on the state of maternal health in Arkansas. Krista Langston is the executive director for community programs for the University of Arkansas for Medical Sciences’ Institute of Community Health Innovations, she said this group was brought together to combat the reality that Arkansas is ranked last in America when it comes to maternal health outcomes.
“It's really unacceptable for us to be ranked so low so that the work group is really a result of how do we work collaboratively to address this issue within our state,” Langston said.
The statistics around maternal mortality are alarming. Keesa Smith-Brantley is the executive director for Arkansas Advocates for Children and Families, and she points out that more than half of the counties in Arkansas are maternal health deserts.
“Meaning that there are either no obstetricians in that area or no hospitals offering prenatal care in that area,” Smith-Brantley said.
Another reality is that there are a number of hospitals in the state that are closing their labor and delivery units.
“So when women become pregnant and they're trying to plan out what will happen when it's time for them to give birth,” Smith-Brantley said, “a lot of them are faced with the fact that the closest hospital may be 30 minutes or more away from their home. And that's particularly concerning for women that are experiencing high risk pregnancies or just women that are living in rural areas where the drive may be a significant amount of time to get there.”
Langston said the fact that Arkansas is such a rural state plays a role in this, in part because rural hospitals are seeing low amounts of births in their labor and delivery units.
“They haven't been able to cover their costs for that,” she said. “And so that is a big impact on the state. And at the institute, we're doing a lot of innovative. We have a lot of innovative strategies to where we're trying to meet the needs that we've launched mobile health units. Our goal is to reach all of the maternal health deserts over the next five years and provide mobile prenatal care to women in these rural counties. We launched last April in Madison County. And you know, the women that we served, it's really heart wrenching to hear their stories and to hear that until the mobile unit came to their county, they literally did not have access.”
She said the top recommendations from the report seek to address access, quality, and data transparency.
“I commend the governor and the team that put their report together by bringing all the maternal stakeholders together and really utilizing those key stakeholders to help inform the strategies within the plan,” Langston said.
That includes creating a dashboard to measure key maternal health indicators as well as Medicaid eligibility for pregnant women. The report said that up to 60% of all pregnancies in Arkansas every year are covered by Medicaid. Smith-Brantley said that statistic is extremely problematic.
“And I think it's a statistic that many individuals do not acknowledge,” she said. “We've gotten past the point that we can just continue to blame individuals for why they're on this program when it's been shown again that a lot of the things that lead to us having such a high Medicaid population is due to the fact that we have not created an economic environment and Arkansas that allows these individuals the opportunity to not live in poverty. And that is really should be one of the things that's most concerning when we start talking about all of the ways in which Medicaid really supports our state.”
Another recommendation from the report is to explore obstetrics and gynecology residency selection reforms to improve OBGYN residency graduate retention in the state, develop a Family Medicine Obstetrics Fellowship and establish a school of midwifery in Arkansas. Smith-Brantley said there may be a number of barriers to accomplish this.
“I do think that without clarity on our regulations against abortion you know without clarity where we say what does it mean for a woman's life to be in danger. When when that is out there and it's just kind of mushy and it lacks really clear definitions then yes you have you know individuals in the medical profession who are having to make tough choices and they you know this is their livelihood and it's hard when you don't know what the clear distinction is. And you also have to look at how we're reimbursing and paying doctors which is a big piece and the report does acknowledge that we have to look at how we reimburse our medical professionals because we're not going to get over this really big hurdle of the lack of of obstetricians without looking at how we're paying them.”
Langston said it’s important to start with the small wins in this effort to improve maternal health across the state.
“Like what can we address quickly but I do think the hardest will be access and training new providers just because it's going to take the longest amount of time.”
When asked what metrics we need to meet in Arkansas in order to say we’ve done a successful job of improving maternal health, Langston said ultimately we would see our birth outcomes improve.
“I think that's the next step for the work group is determining what what does that performance scorecard look like and how can we say that we've achieved the goal and that we've set out to achieve but for my human perspective just being able to say that we produce the number of deaths related to maternal health would be a big win.”
Leaders in Arkansas have called this the most Pro-Life state in America. When asked her reaction to this title, Smith-Brantley said it’s time to evaluate why we’ve given ourselves that title.
“Banning abortion alone cannot be why we call ourselves pro-life. We have to look at again the how safe it is for a woman to give birth, how safe it is for her child when she gives birth. What care are we providing for that woman almost immediately after she gives birth. Otherwise, you know, it's concerning for us to say that we're pro-life when we know that there are all of these barriers and hurdles that pregnant women in our state are experiencing and we're not addressing them in the way that we should. We're making we're making steps and I would say that there are it's encouraging to see the number of individuals who are looking at this matter and getting fired up about the fact that we need solutions. But as you can tell from the outcomes that we've had for years, we are well-passed to kind of talking through ideas. We're at the point where we actually absolutely have to have action taken place.”
Ozarks at Large transcripts are created on a deadline. This text may not be in its final form and may be updated or revised in the future. The authoritative record of KUAF programming is the audio record.
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