Partnership among stakeholders and renewed education efforts will go a long way toward improving Arkansas’ low rankings in maternal health, medical and political leaders said recently.
The University of Arkansas for Medical Sciences hosted a “Maternal Health Roundtable” on February 21 organized by U.S. Sen. John Boozman of Arkansas.
“Healthier women make healthier moms and healthier babies,” said Gov. Sarah Huckabee Sanders. “I’m the first mom to serve as governor. It’s very personal to me. The care I received I want every mom to have access to.”
Dr. Lanita S. White, chief executive officer of Community Health Centers of Arkansas, was among the state healthcare leaders to join the discussion.
“We need to explain to women when they are at high risk [for adverse maternal health conditions],” White said. “The responsibility of the patient begins when we make them aware of what they need to do. We need to incorporate [maternal health care] into our conversations in patient visits so that it’s just like [discussions about] blood pressure. We need to normalize the conversation. We don’t want [patients] to feel stupid. We need to use plain language.”
Congressman French Hill of Little Rock; Dr. Nirvana Manning, an obstetrician/gynecologist at UAMS; Dr. Sharmila Makhija, founding dean of the Alice Walton School of Medicine; and Dr. William “Sam” Greenfield, an obstetrician/gynecologist at the Arkansas Department of Health were the other panelists. Jodiane Tritt, executive vice president of the Arkansas Hospital Association, moderated.
Tritt said the number of Arkansas hospitals that deliver babies is declining, down to 35 currently.
Sanders said that too many pregnant women in Arkansas – one in 35 -- aren’t seeing a doctor until it’s time to deliver.
Greenfield said there are opportunities for medical care that too many women just don’t know about.
Sanders said every pregnant woman has an opportunity for medical care because of existing programs.
She and Hill each pointed to the availability of Community Health Centers for maternal care.
“We are not coordinating the access we have,” Hill said.
As examples of positive programs to help young families, Boozman and Sanders pointed to the expansion of the federal WIC [Women, Infants, and Children] program that among other things now provides food during the summer for school children. States had the option of expanding the program for the summer, which Sanders did for Arkansas.
Among legislators in the audience, Rep. Mary Bentley of Perryville touted the importance of breastfeeding and Sen. Dan Sullivan of Jonesboro maintained that the responsibilities of fathers shouldn’t be forgotten.
Boozman warned of a 3 percent cut in Medicare reimbursements to medical providers. Sanders acknowledged that Medicaid reimbursements needed addressing. She didn’t have specifics, saying that “everything is on the table.”
Keesa Smith, executive director of Arkansas Advocates for Children and Families, said that she was hearing “a lot of talk” and wanted to know the “next steps” for advancing maternal health policy.
Sanders said her administration is working on a “comprehensive statewide plan” and that it’s “important people are paying attention.”
Allan Nichols, chief executive officer of Mainline Health Systems of Monticello and a member
of the Community Health Centers of
Arkansas Board of Directors, said that a “core issue” for rural areas is for their local clinic to maintain a viable practice of obstetricians/gynecologists. At least four of those providers are needed at a clinic to have a practical rotation.
“Two hundred deliveries per year for each are needed to [financial make the service work],” Nicholls said. “We need a coordinated plan in the state or we will waste resources.”
Hill said, “I couldn’t agree more.”
After the panel session, Sanders told reporters that she opposed expanding postpartum maternal care through 12 months. That is an option recently offered by the federal government that most states have taken advantage of. The current cutoff is two months for care after birth.
The Department of Human Services told the Arkansas Democrat-Gazette that women who no longer qualify for Medicaid may seek coverage through a subsidized plan in the Health Insurance Marketplace or from an employer.
Arkansas has the highest known rate of maternal mortality in the U.S., according to the CDC.