Legislators and state officials continue to work on methods of improving maternal health care in Arkansas.
A special committee created by the governor last week issued its recommendations in a report called “Healthy Moms, Healthy Babies.” It calls for making access to health care more clear and convenient for expectant mothers.
It also listed ways for medical providers to recognize when pregnant women are at risk of losing their health coverage. It recommends steps to make sure that women have some type of health insurance and are aware of the services available.
The lack of obstetricians in rural Arkansas is a challenge, so the committee recommended creating a loan forgiveness program for maternal care providers. One method is to increase the number of residencies in obstetrics and gynecology. Another would be to establish a school of midwifery.
Another recommendation was to create a process by which doulas and community health workers can get certified and receive Medicaid reimbursements. A doula is a woman who provides guidance and help during labor, and after delivery. Doulas provide physical and emotional support, with expertise in breathing techniques and breastfeeding.
Medicaid, a government health program for low-income families, pays for more than half the deliveries in Arkansas. Adding doulas and community health workers to the list of approved Medicaid providers could significantly increase the availability of maternal care in isolated parts of the state.
The report also recommends evaluating reimbursement rates for all aspects of maternal care, including family planning and contraception.
The state Health Department operates local clinics throughout Arkansas, and the department is assessing whether each one needs to enhance maternal health care.
A report by the March of Dimes points to the urgency of expanding maternal care options. According to the organization, 38 of the 75 counties in Arkansas lack a hospital or birthing clinic with obstetric care providers.
Nationwide, about a third of all counties lack obstetrics services, according to the March of Dimes report.
Last December another special committee created by the legislature in 2019 issued a lengthy report that identified specific illnesses that are most prevalent in pregnant women in Arkansas, and recommended strategies for improving treatment.
The leading cause of death among those 38 was cardiomyopathy, a disease of the heart muscles. The second leading cause was cardiovascular conditions caused by high blood pressure, diabetes, smoking, obesity and age.
In last year’s legislative session lawmakers approved Act 562 requiring Medicaid to reimburse providers when they screen pregnant women for depression. An early diagnosis can dramatically help prevent the negative effects of postpartum depression.
Legislators also approved Act 553 to mandate that the state Medical Examiner conduct a postmortem examination of any woman who dies within 365 days of being pregnant, if the death is possibly related to the pregnancy. By identifying the serious medical conditions that harm a pregnant woman’s health, physicians can better treat and prevent them.
Act 581 of 2023 requires Medicaid to reimburse physicians and clinics for providing reversible contraception immediately and during postpartum.
