Panelists say telemedicine, doulas could improve Arkansas’ poor maternal health outcomes

U.S. Senator John Boozman (R-Arkansas) speaks at a roundtable discussion on maternal health at Crystal Bridges Museum of American Art in Bentonville on Aug. 21, 2024. (Antoinette Grajeda/Arkansas Advocate)

Participants in a maternal health roundtable discussion in Bentonville Wednesday morning said education, collaboration, meeting patients where they are and telemedicine are all strategies for addressing Arkansas’ poor maternal health outcomes.

Arkansas has one of the nation’s highest maternal mortality rates and the third-highest infant mortality rate, according to the Arkansas Center for Health Improvement .

A panel of maternal health experts joined U.S. Sen. John Boozman at Crystal Bridges Museum of American Art, where museum board chair Oliva Walton moderated the discussion. Walton is also the founder and CEO of Ingeborg Investments, which is focused on improving maternal health, advancing women’s economic opportunity and expanding access to quality care and early learning opportunities for children, according to its website .

Boozman, who participated in a Little Rock maternal health roundtable in February, told reporters Wednesday that the goal is to host these events in all four of Arkansas’ congressional districts this year. Boozman said a key part of addressing the state’s maternal health crisis is educating Arkansans about available resources.

“I think the most important thing is education, making sure that people understand that there are programs out there,” he said. “…[the] federal government provides these dollars, we’ve got to inform people that they’re there, and I think you have to go to where [people are].”

Medicaid is an important federal program in Arkansas, where more than half of births are covered by the program, Department of Human Services Kristi Putnam told lawmakers in March .

Arkansas is one of two states that has not or has no plans to take advantage of a federal option to extend postpartum Medicaid coverage from 60 days to 12 months after birth, according to KFF . A 2023 bill would have extended this coverage but did not advance in the Legislature due to cost concerns.

At February’s maternal health event , Gov. Sarah Huckabee Sanders said better education about available programs, not necessarily additional legislation, was needed to help Arkansas moms. Sanders said the Medicaid option would “create a redundant program” during a March press conference where she signed an executive order creating the Arkansas Strategic Committee for Maternal Health, which was tasked with creating a statewide strategic maternal health plan.

Arkansas maternal health care landscape needs more coordination and teamwork, physicians say

Secretary of Health Renee Mallory said Wednesday that the group is preparing to deliver a report to the governor around the first of September and that some of its recommendations deal with Medicaid and reimbursement rates.

Boozman, a former optometrist, said Medicaid reimbursement rates pose “a huge problem in medicine” and as a result, some physicians may limit accepting Medicaid patients.

“If it costs you more money to provide a service than what you’re actually going to get, it’s difficult,” he said.

This can further limit access to physicians in a rural state that already struggles with health care access. Some of Arkansas’ 75 counties do not have hospitals , while only 35 hospitals in the state have labor and delivery units.

Cara Osborne, a nurse midwife and panel participant, said a broad range of professionals can participate in the maternity care and delivery system. Arkansas’ system, like many other places, has defaulted to physicians in hospitals, but it’s not sustainable, Osborne said.

“At the national level, we have the most alarming maternity care statistics of any developed country. It is the system who is broken,” she said. “It’s not the people, it’s not the women that are broken and it’s not the physicians or the providers. Nobody’s done something wrong here. It’s the way that the system has developed.”

Panel participants discussed the importance of training more midwives and doulas as one way to tackle the state’s maternal health crisis.

In April, lawmakers approved redirecting $500,000 from the Arkansas Center for Health Improvement to support a new certified midwifery program at the University of Arkansas for Medical Sciences, which the school plans to begin in 2026. Meanwhile, the Doula Alliance of Arkansas announced its launched earlier this month thanks to a $250,000 seed grant from Ingeborg Initiatives.

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