HJAR May/Jun 2026

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2026 17 Arkansas has one of the highest maternal mortality rates in the United States. Infant health outcomes such as low birthweight, preterm birth, and infant mortality are also significantly worse than national averages. Historically, the state had lower rates of first trimester prenatal care, with 29% (more than 10,000) women receiving late prenatal care and 2.5% (almost 1,000) receiving no prenatal care. Maternal health disparities in Arkansas are driven in large part by geog- raphy and workforce shortages: The state is predominantly rural and most counties are designated Health Professional Short- age Areas. Several hospitals have closed their labor and delivery services. Hospitals with labor- and-delivery units are located in only 22 counties of Arkansas’s 75 counties and many counties do not have obstetrical care pro- viders, forcing long drives and reduced pre- natal utilization, and ultimately, increased maternal morbidity and mortality. Prenatal care in the first trimester is associated with better health outcomes for both moms and babies. In an effort to improve maternal health in the state, Gov. Sarah Huckabee Sanders signed an exec- utive order in March of 2024 that formed the Arkansas Maternal Health Taskforce. And in 2025, Arkansas Act 124 (HB1427), “Healthy Moms, Healthy Babies,” was signed. The “momnibus legislation”focuses on improvements to the current system, including establishing presumptive Medic- aid eligibility for pregnant women and pro- viding reimbursement pathways for doulas and community health workers (CHWs). It also authorizes pregnancy-relatedMedicaid coverage for remote ultrasounds, remote blood pressure monitoring, and continuous glucose monitoring. Other keyArkansas legislation passed in 2025 includes Arkansas Act 965 (HB1252) to establish a statewide birth and postpar- tum doula certification through the Arkan- sas Department of Health (ADH); Arkansas Act 435 (HB1258) to establish a statewide CHW certification through ADH; Arkansas Act 627 (HB1333), which extends Medicaid reimbursement to professionals provid- ing breastfeeding and lactation consulting services; and Arkansas Act 866 (HB1826), which mandates insurance coverage for births at licensed birthing centers. Transforming Maternal Health In 2025, Arkansas was one of 10 states to receive funding through the Transform- ing Maternal Health Model (TMaH). The TMaH award supports Arkansas’ Medic- aid program and stakeholders in develop- ing a whole-person approach to pregnancy, childbirth, and postpartum care, with the goal of improving access, treatment, out- comes, and experiences for mothers and their newborns, while simultaneously reducing overall program expenditures. Arkansas’ TMaH grant focuses on three main pillars: 1) access to care, infrastructure, and workforce capacity; 2) quality improve- ment and safety; and 3) whole-person care delivery. The funding will allow the state to strategically manage maternal health data; encourage increased leveraging of doulas, CHWs, and midwives; employ technology to expand perinatal care; reform Medic- aid incentives; and strengthen ties between providers and community-based organi- zations. The TMaH award and the Healthy Moms, Healthy BabiesAct strategically align across priorities. TheArkansas Maternal Health Taskforce, which includes more than 150 stakeholders across the state, has rapidly implemented several initiatives, including legislation, training programs, healthcare access ini- tiatives, and research. Let’s take a look at some of those efforts. Training Programs Doulas. Doulas are trained perinatal pro- fessionals who provide emotional, physi- cal, and educational support throughout pregnancy, childbirth, and the postpar- tum period. Research shows that doula care improves birth outcomes by reducing rates of induction, cesarean section, preterm birth, and low birthweight, while increas- ing breastfeeding and positive infant-care practices. Doula support lowers the risk of postpartum depression and other maternal morbidities, contributing to reduced mater- nal and infant mortality. In preparation for the reimbursement provided through new legislation, stake- holders formed the DoulaAlliance of Arkan- sas and have worked with Ujima Maternity Network and Birthing Beyond to train dou- las and expand doula services throughout the state. The training program includes options for Doulas of NorthAmerica Inter- national certification and Breastfeed- ing Counselor certification. In addition to intensive didactic education, coaching and mentoring are provided for six months by an experienced doula, and trainees attend T H E T R A N S F O R M A T I O N of Maternal Health in Arkansas by Pearl McElfish, PhD, MBA Director, Institute for Community Health Innovation