Northwest Arkansas Health Summit panelists discuss solutions for maternal health barriers

FAYETTEVILLE — There are opportunities to improve maternal health outcomes in Arkansas, panelists at the Northwest Arkansas Health Summit said Wednesday.

The Northwest Arkansas Council presented the summit, which was designed to identify and address barriers Arkansas experiences in maternal health.

Arkansas had 54 pregnancy-associated deaths between 2018 and 2019, which presents a pregnancy-associated mortality ratio of 73.7 deaths per 100,000 births, according to a legislative report published in December 2022. The report also showed that Black non-Hispanic mothers were twice as likely to die pregnancy-related deaths compared to white non-Hispanic mothers in Arkansas.

Members of health care organizations and community-based organizations, city and county leaders, and industry stakeholders attended Wednesday’s summit and learned about specific obstacles mothers face in the prenatal and postpartum periods.

Kalena Jones, a system director at Baptist Health, shared information about a new program called “Maternal Infant Health Outreach Workers” the system has been internally promoting and offering to its patients, particularly in underserved communities.

The program focuses on milestones and helps families receive early intervention if a baby is showing a delay in any skills. It includes monthly home visits, access to the maternal navigator program at Baptist Health, monthly clinic visits and deployment of mobile health units that offer increased access to community health workers in all parts of the state.

Laura Kellams with Arkansas Advocates for Children and Families said no policy is magic and can change everything, but there are fairly attainable policy opportunities that Arkansas hasn’t taken advantage of.

She said presumptive eligibility is a policy Arkansas could introduce to improve postpartum care and create better access to prenatal care.

According to medicaid’s website, states can authorize “qualified entities,” such as health care providers or community-based organizations, to screen for medicaid and immediately enroll people who appear to be eligible.

Kellams said another way the state could lower negative maternal outcomes through policy would be to require sex education in schools. She said currently the state doesn’t require sex education of any kind, but the teaching must include abstinence if it is given.

Arkansas has statistically been the worst in the nation for the last decade in teen births, Kellams said. She said teen birth contributes to poverty and strains medicaid resources.

Improving medicaid policy by extending postpartum coverage for mothers from 60 days after delivery to 12 months would improve maternal outcomes as well, Kellams said, but she added Arkansas has refused to approve the extension.

Rep. Aaron Pilkington, R-Knoxville, sponsored Bill 1010, which would have required medicaid coverage for postpartum mothers for one year after giving birth. The bill died in House Committee.

State Rep. Lee Johnson, R-Greenwood, said the state is at a place where people know the issues the state faces and can start thinking about solutions that can become actions.

Johnson, who is also an emergency room physician, said the state has responded to medical crises before, such as creating a state trauma system in hospitals that decreased patient deaths by 50% and AR Saves, a stroke education program that has created a 20% reduction in stroke mortality.

The state has proven that it can identify a problem and reduce it, Johnson said.

Physicians only receive $1,200 in medicaid reimbursement per birth, said SaraBeth Askins with Baptist Health.

According to a recent study by Heartland Forward, the cost of financial inactivity in maternal health is causing greater strain on the economy.

Heartland Forward reports that, according to data from from 2018 to 2020, the economic impact of maternal mortality in the U.S., in terms of lost potential human capital, was valued near $27.43 billion for the nation. In Arkansas, that number was closer to $1.1 billion.

The public needs to be educated on community health workers, such as doulas and midwives, said Ross DeVol, president and CEO of Heartland Forward. He said that education would not be advocating for less doctors of obstetrics and gynecology, but advocating for all maternal health professionals to be a part of the solution.

A couple ways Heartland Forward plans to address maternal health gaps is by supporting community health care workers through educating the public on their importance and expanding their presence in maternal health care and finding innovative ways for access to transportation.

“We have built this country assuming everyone can afford a car, the gas and the maintenance for that car,” said Maria Rodriguez-Alcala, the director of health and wellness at Heartland Forward.

Shannon Case, a doctor of obstetrics and gynecology at Johnson Regional Medical Center in Clarksville, said at her practice she sees a need for transportation and social work.

Heartland Forward’s research also shows that around 40% of mothers in Arkansas receive prenatal care and deliver outside of their county. DeVol said that out-of-county childbirth can mean a lower number of prenatal visits and less visits are often connected to undesired outcomes.

Nine prenatal visits is considered adequate, said Pearl McElfish, director of UAMS Community Health and Research.

“We must do our best to prevent the preventable,” DeVol said.

    State Rep. Lee Johnson, R-Greenwood, speaks Wednesday during a breakout session as a part of the 2024 Northwest Arkansas Health Summit at Fayetteville Town Center. The main focus of the summit was identifying and addressing barriers related to maternal health in Arkansas. Visit nwaonline.com/photos for today’s photo gallery. (NWA Democrat Gazette/Caleb Grieger)
  

    State Sen. Missy Irvin, R-Mountain View, speaks Wednesday during a breakout session as a part of the 2024 Northwest Arkansas Health Summit at Fayetteville Town Center. The main focus of the summit was identifying and addressing barriers related to maternal health in Arkansas. Visit nwaonline.com/photos for today’s photo gallery. (NWA Democrat Gazette/Caleb Grieger)
  

    State Rep. Aaron Pilkington (from left), R-Knoxville; state Rep. Mary Bentley, R-Perryville; moderator John Burris; State Sen. Missy Irvin, R-Mountain View; and state Rep. Lee Johnson, R-Greenwood, speak Wednesday during a breakout session as a part of the 2024 Northwest Arkansas Health Summit at Fayetteville Town Center. The main focus of the summit was identifying and addressing barriers related to maternal health in Arkansas. Visit nwaonline.com/photos for today’s photo gallery. (NWA Democrat Gazette/Caleb Grieger)
  

    State Rep. Aaron Pilkington (from left), R-Knoxville; state Rep. Mary Bentley, R-Perryville; moderator John Burris; State Sen. Missy Irvin, R-Mountain View; and state Rep. Lee Johnson, R-Greenwood, speak Wednesday during a breakout session as a part of the 2024 Northwest Arkansas Health Summit at Fayetteville Town Center. The main focus of the summit was identifying and addressing barriers related to maternal health in Arkansas. Visit nwaonline.com/photos for today’s photo gallery. (NWA Democrat Gazette/Caleb Grieger)
  

    State Rep. Aaron Pilkington (from left), R-Knoxville; state Rep. Mary Bentley, R-Perryville; moderator John Burris; State Sen. Missy Irvin, R-Mountain View; and state Rep. Lee Johnson, R-Greenwood, speak Wednesday during a breakout session as a part of the 2024 Northwest Arkansas Health Summit at Fayetteville Town Center. The main focus of the summit was identifying and addressing barriers related to maternal health in Arkansas. Visit nwaonline.com/photos for today’s photo gallery. (NWA Democrat Gazette/Caleb Grieger)