For too long, maternal health outcomes in Arkansas have reflected a persistent crisis, particularly for women in rural areas and those insured by Medicaid. At the University of Arkansas for Medical Sciences in Little Rock, we refuse to accept that geography, race or income should determine whether a mother survives pregnancy or receives the care she deserves. That belief is the foundation for our innovative and collaborative approach to improving maternal health outcomes across the state. We are committed to creating a system where every mother in Arkansas has access to the care and support she needs before, during and after childbirth.
One of the most direct ways we are closing the gap in care is through our mobile health units. In light of hospital closures and the reduction of obstetric services in many communities, these units serve as mobile clinics that deliver critical services directly into underserved areas. They provide well-woman exams, prenatal and postpartum care, mental health screenings and contraceptive services, all coordinated by a dedicated team of providers and community health workers. By eliminating transportation challenges and other logistical barriers, we are making high-quality maternal care available to women who might otherwise go without.
We are also expanding access to doulas, who offer compassionate and continuous support during labor and delivery. Doula care is associated with lower rates of cesarean deliveries, fewer birth complications and increased satisfaction with the birth experience. For many women, doulas often serve as essential advocates within complex health care systems. Through our partnership with the Doula Alliance of Arkansas, we are increasing the number of trained and certified doulas in the state and providing scholarships to help build a workforce that reflects the diverse communities we serve. These doulas are not only present in birthing rooms but are becoming integrated into the broader clinical care teams across hospitals.
Another key innovation addresses the issue of unintended pregnancies, which affect 54 percent of women in Arkansas. Closely spaced pregnancies and lack of postpartum contraception can lead to serious consequences, including delayed prenatal care, maternal hemorrhage, increased neonatal intensive care unit stays and even infant death. To reduce those risks, UAMS developed the Immediate Postpartum Long-Acting Reversible Contraceptive Initiative. The program gives new mothers the opportunity to receive long-acting contraception before leaving the hospital after childbirth.
Over a two-year pilot, we saw outcomes that surpassed national benchmarks. Our patients had lower rates of short-interval pregnancies and reported greater satisfaction with their ability to plan for their reproductive futures. Those results helped pave the way for the passage of House Bill 1385 in 2023, a critical piece of legislation that now allows all birthing hospitals in Arkansas to receive Medicaid reimbursement for immediate postpartum LARC insertion. This policy shift reflects how research, patient-centered care and legislative action can come together to create long-term improvements in reproductive care.
To ensure that these innovations are adopted statewide, collaboration has been essential. UAMS works closely with the recently announced Arkansas Center for Women & Infants’ Health and the Arkansas Perinatal Quality Collaborative to build capacity and standardize care. Through the Alliance for Innovation on Maternal Health, Arkansas has adopted evidence-based clinical protocols to better manage obstetric emergencies such as hemorrhage, hypertension and complications from cesarean sections. ARPQC provides hands-on training in hospitals across the state to ensure that staff are prepared to deliver consistent, high-quality care even in high-stress situations or amid staffing challenges.
In August, UAMS co-hosted the Arkansas Maternal Health Roundtable with the Arkansas Hospital Association. The event convened representatives from the 33 delivering hospitals in Arkansas and served as a catalyst for collaboration, alignment and shared accountability. Participants engaged with data, exchanged best practices, and discussed strategies for implementing both legislative changes and clinical improvements in a sustainable and patient-centered way.
Data continues to guide our work. The Arkansas Maternal Mortality Review Committee, established in 2019, has completed four years of maternal death reviews. The data is sobering: 92 percent of maternal deaths in Arkansas have been deemed preventable. This statistic demands not only our attention but our action. It reinforces the importance of the interventions we are pursuing, from Medicaid-covered contraception and doula support to emergency preparedness and mobile access.
The efforts are not just innovative — they are effective. We have already seen improved outcomes, increased engagement and greater patient and provider satisfaction across our programs.
We believe Arkansas can and must lead the way in redefining maternal health. We are proving that it is possible to build a system that honors the dignity of every mother and baby, regardless of their circumstances. We are committed to continuing our work in collaboration with partners, patients and communities who share our vision. Together, we can make Arkansas a safer and healthier place to give birth.
Krista Langston is executive director of community programs at the UAMS Institute for Community Health Innovation.
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