In February 2025, the Arkansas Legislature passed the Healthy Moms, Healthy Babies Act, which, among other things, invests more than $45 million annually toward improving maternal health in the state. One major stakeholder working to pull Arkansas out of the basement when it comes to maternal health statistics is Heartland Forward. The Bentonville-based organization works across 20 states in the heartland to improve economic performance and health outcomes in the middle of the country. Angie Cooper is the president of Heartland Forward. We spoke late last week about some of the initiatives they're working on in Arkansas in coalition with the Healthy Moms, Healthy Babies Act. Cooper says part of their work has been bringing together key leaders, everyone from providers to policymakers to community leaders.
Angie Cooper: To really take this landmark legislation and put it into action for moms, babies and families in our communities.
Matthew Moore: Give us a little bit of, like, concrete examples here of the kind of work that you and your team at Heartland Forward are doing to play a role in making this more than just a bill that's passed, but things that are actually happening.
Cooper: We last year at Heartland Forward created a Maternal and Child Health Center for Policy and Practice. And we said the center, because of the legislation that was passed in Arkansas and to work towards goals specifically in the state in which we're based, we said we're going to incubate some of these practices in Arkansas to cut maternal mortality in half and to really make clear goals and activities to help support moms and babies. And so we have been convening like-minded folks. We have had two convenings in the state of Arkansas and will continue to do that. But some of the early wins that we've seen — we have helped train 70-plus doulas. There is a call center that has been created. Think: mom has baby, and sometimes the doctor says, "I'll see you in six weeks." Mom actually needs to talk to someone in the next three hours. And so this call center has already reached 77% of new moms. We're creating opportunities for home visits. And because of legislation in Arkansas that was passed to enhance community health workers, we're really putting a whole team around mom and baby so they can stay healthy and grow and flourish. So we can create healthy communities for the state of Arkansas.
Moore: Ozarks at Large has actually covered that call center. We've done a lot of this sort of coverage about how are we doing the work that needs to be done to improve maternal health and infant health here in the state of Arkansas. As you well know, the statistics have been pretty bad across the board for Arkansas. We're seeing some improvements. What are some ways that you are thinking about — UAMS, they're a great partner, I'm sure, in a lot of the work that you're doing — what are some other more creative ideas, or maybe outside-the-box ideas, that you're thinking about in a way to say, maybe we need to do something besides the status quo?
Cooper: We work with a lot of partners, and the convening power and being able to share best practices and resources with folks like UAMS, with local providers, with doulas and midwives and training and educational opportunities — that's what we're trying to do. How do we bring people together to drive action? But we know what works. When Heartland Forward created the Maternal and Child Health Center for Policy and Practice, we took a playbook that was created by leaders from across the country with the National Governors Association. And we've seen success from states like New Jersey that took maternal health from 48th to 25th within seven years. So while we're going to continue to be innovative, while we're going to continue to drive new things to the state of Arkansas, there is a playbook that works. And that's why we believe the time is now to act. And we know 87% of deaths are preventable. In fact, the maternal mortality rates are worse than when my mom had me. So again, why shouldn't we act? Why should we not continue to put policy into practice — not only for the health of moms and babies, but as an organization, Heartland Forward, that works to accelerate economic growth for Arkansas and communities across the heartland? We know and have estimated there's $8,872 million in savings if we just take preventative measures. So that's what we're excited about. We can't do it alone at Heartland Forward. We need state leaders at the Capitol, we need local leaders in their communities, and then we need the experts to help us to drive real change for Arkansas and for the rest of the heartland and the country.
Moore: I would imagine one of the advantages that you have as someone who works across the heartland is you have conversations and access to policymakers and state leaders in other states. How are those conversations with, say, people in other states who are doing better or are seeing improvements in their maternal health numbers, informing the conversations you're having with leaders in Arkansas?
Cooper: It's really, really important. While we're doing a lot of work specifically in Arkansas and the Healthy Moms, Healthy Babies Act is really key, leaders in Oklahoma are looking at the exact same type of legislation. The state of Michigan has done some really exciting things as it relates to home visits. Because when we think about a lot of heartland communities, on average, a mom could be driving 100 miles to go see their doctor. So there are lots of great examples that we can point to in various states. We also know the state of Arkansas and states in the heartland and across the country are going to be able to benefit from federal opportunities and resources through the Rural Health Transformation program. And so how do we bring all of these ideas together to, again, help support moms, babies and healthy communities so we can all thrive?
Moore: There are three pillars that you really talk about kind of leaning on here. When we're thinking about this bigger picture, you're thinking about policy, you're thinking about access and you're thinking about workforce too. And you've laid out some examples of a lot of these things. When we're thinking about policy, obviously this legislation fits into that world. When we're thinking about workforce, you're talking about doulas. Tell me more about the access element of this, because when we think about Arkansas, it's a very rural state. As you just mentioned, people might have to drive upwards of an hour, if not more, to get to a health care provider. All of these can be barriers that prevent people from getting the access to health care that they deserve and they need. What are some ways we're seeing that be approached?
Cooper: We're focused on kind of three main initiatives within this work. The first is prenatal. The second is postpartum. And the other is how do we make this good for business and good for communities? So on the prenatal piece, we're working with partners to really get education out there. If mom now knows she's going to have a baby, how do we get creative on access? This is creating telehealth services. This is expanding scope of practice. This is also nutritional and education opportunities. Because a lot of times when a mom becomes pregnant, it's some of the first time she's really been seeing a doctor multiple times in a short span. We also need to remember that when mom is pregnant, she's not sick. So these prenatal things around the healthy lifestyle are really, really important. Postpartum is also important. And that's why we're really excited to continue to grow that call center, so that mom and families can ask the questions that they need and they can get the access without driving to go see a local provider. We can use innovation and we can use technology to do that. And then we need more doulas, we need more midwives, we need more community health workers — those trusted care providers — when the family has a lot of serious things that they're looking at when baby is born. And so that's what we want to continue to drive. And we just can't thank our partners enough for really looking for solutions and wanting to roll up their sleeves to make sure that we can prevent deaths from happening in the future.
Moore: What's been harder than you expected?
Cooper: There's so much work to be done. You look at the numbers and you look at the stats, and people are surprised to know that it's worse from when my mom had me. And so it's how do you really start focusing in and prioritizing so we're working on the right things at the right time.
Moore: When you think about where the state of Arkansas is now here in 2026, and if we want to go to a round number, let's say 2030 — four years from now — where do you hope to be able to look back on and say, here are the concrete things we did, and here are the changes we're seeing in our community for people across the state of Arkansas?
Cooper: We want to make sure that, first and foremost, we cut maternal mortality in half in five years. That is our goal. We're going to work to do that in Arkansas. We're going to work to do that across the heartland. And we think this is a national priority. We want to raise that issue so everyone's thinking about it. And then we want to make sure that through this work, it leads to more innovation and care. It leads to more access in rural Arkansas. And that it also shows that if you do take care of mom and baby, you can truly drive economic success in the future — across the state of Arkansas and across the 20 states in the heartland.
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