By TESS VRBIN | Arkansas Advocate

Some Arkansas lawmakers said Thursday that they see pregnancy resource centers as tools to help reduce infant, child and maternal mortality in the state, which has a near-total abortion ban and consistently high rates of death among babies and new mothers.

Pregnancy resource centers — often referred to as “crisis pregnancy centers” — are often religiously affiliated and discourage abortion while encouraging birth. Arkansas has more than 40 of these centers that operate independently but form a community, the Arkansas Pregnancy Network, due to their shared missions and similar services, said Maria Speer, executive director of the Life Choices center in Conway.

These centers typically offer pregnancy tests, ultrasounds, parenting classes and baby supplies, all at no cost to clients. Some also offer financial assistance for pregnant people, mental health counseling and testing for sexually transmitted infections.

Some clients at Caring Hearts Pregnancy Center in Little Rock and North Little Rock cannot afford to receive prenatal health care elsewhere, executive director Donna Ezell told the state’s Joint Public Health, Welfare and Labor Committee on Thursday.

“A lot of times it’s because they’re still waiting on their Medicaid approval… or they’re in that gap where they don’t meet qualifications for pregnancy Medicaid, and yet they’re still low-income and they know there will be significant out-of-pocket [costs] when they go in for prenatal care,” Ezell said.

The committee also heard from Shelley Lewis, executive director of Arkansas Pregnancy Resource Center, which is next door to Little Rock’s Planned Parenthood location.

Republican leaders statewide have held up pregnancy resource centers as critical since the U.S. Supreme Court overturned Roe v. Wade in June 2022 and left abortion access up to individual states. Arkansas had a “trigger law” in place to outlaw abortion in nearly all circumstances, unless the pregnant person’s life is at risk, immediately upon the Dobbs v. Jackson ruling.

Some pregnancy resource centers in Arkansas have reported increases in demand for their services since the Dobbs ruling, Speer said, citing a survey of 20 centers.

Additionally, the state’s abortion access groups have seen their costs increase over the same time period, and many Arkansans have sought permanent sterilization or long-acting reversible contraception in response to the trigger law, the Arkansas Advocate reported in June.

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

Sen. Missy Irvin, R-Mountain View, the committee’s Senate chair, said she hopes pregnancy resource centers can be “partners” with the state in mitigating these issues.

The Joint Public Health committee also heard a report on Thursday on infant and child deaths throughout the state in 2020 from the Arkansas Infant and Child Death Review (ICDR) Program at Arkansas Children’s Hospital. The program reviewed 110 of the 470 child deaths in Arkansas in 2020 and labeled their causes accidental, homicide, suicide or undetermined. Irvin said she wanted the committee to hear the ICDR report and have discussions with pregnancy resource center directors at the same meeting.

“Promoting women’s and children’s health and the wellbeing of families could lead to a lot of prevention of the deaths that we heard about [in the report],” Irvin said. The Legislature’s Joint Children and Youth committee heard the ICDR report in June. Most of the 34 undetermined deaths were “related to sleeping or sleep environment” and “predominantly occurred in adult beds,” the report states.

Speer said representatives from Arkansas Children’s Hospital have sometimes assisted with the center’s parenting classes and included instructions on safe sleeping practices.The ICDR data also reported 18 child suicides in 2020 and showed a slightly higher suicide rate among girls than boys.

“We don’t know how many of these are young women that may have committed suicide because they became pregnant and didn’t have anywhere to turn,” Irvin said.

Chemical abortions in Arkansas

Speer said the Arkansas Pregnancy Network centers are aware that some Arkansans are still able to obtain abortions despite the state’s ban by traveling to states where abortion is legal, such as Kansas and Illinois, or by ordering medication online that induces abortions.

Medically induced abortions come from a two-pill regimen: mifepristone, which blocks the hormone that keeps fetal tissue alive, and misoprostol, which expels the tissue from the body.

Speer said no one should order medicine online without first speaking to a medical professional because “you don’t know what you’re getting.” She acknowledged that the Legislature might not be able to stop abortion pills from entering the state but asked the committee to consider other means of discouraging the public from ordering the pills.

“I do want it to remain something in your heads and in your hearts, because that is a crisis for women in Arkansas,” Speer said.

She and Sen. Dan Sullivan, R-Jonesboro, both referred to the effects of abortion medication as delivering a baby. Sullivan, the committee’s Senate vice chair, asked if medication abortion data could be added to future ICDR reports. Speer said there is no way to obtain an accurate number of how many Arkansans have chemical abortions since they are done privately.

Ezell said some clients come to pregnancy resource centers for advice after ordering abortion pills but not yet taking them.

“We’re glad that they’re doing that and trusting us enough to tell us that,” she said. Some pregnancy resource center websites say they offer “abortion pill reversal” — the claim that the effects of mifepristone can be reversed before taking misoprostol. Speer included it in her presentation to the committee.

This claim is not supported by science, according to the American College of Obstetricians and Gynecologists. Some legislators at Thursday’s meeting pointed out that the abortion medication regimen is also used to treat miscarriages.

“There are appropriate times to use these drugs, and there are inappropriate times,” said Rep. Lee Johnson, R-Greenwood, who is a physician and the committee’s House chair. “What we need to do is trust our physicians and hold our physicians accountable to appropriate behavior through the [state] medical board, rather than outlawing these medications.”

In April, a federal judge in Texas ordered the revocation of the U.S. Food and Drug Administration’s approval of mifepristone. The U.S. Department of Justice appealed the ruling soon afterward, and mifepristone has remained available in states with abortion access while the case is expected to go to the U.S. Supreme Court.

Two bills meant to restrict medication-induced abortion in Arkansas were introduced late in this year’s legislative session but were never heard in committee. One would have banned chemical abortions and the other would have increased the criminal penalties for violating state law regarding abortion-inducing drugs.

A bill that did become law, Act 702 of 2023, allows the state to revoke physicians’ medical licenses if they are found to have violated Arkansas’ abortion-inducing drugs law.

Marketing efforts and future endeavors

Last year, Lewis and Ezell successfully applied for portions of a $1 million grant fund the state set aside for pregnancy resource centers, adoption agencies and maternity care homes.

Arkansas Pregnancy Resource Center received $40,000, Caring Hearts received $39,960, and 21 other facilities throughout the state received assistance between September 2022 and January 2023.

Digital advertising was a shared priority among several recipients, including Caring Hearts and Arkansas Pregnancy Resource Center, both of whom sought the grant money to target ads toward Arkansans with online activity suggesting they might have an unplanned pregnancy.

The Legislature passed a law in April rebooting the taxpayer-funded grant. The state Department of Finance and Administration will start accepting applications in September, spokesman Scott Hardin said in an email.

Some pregnancy resource center directors, including Speer, declined or hesitated to apply for last year’s grant out of fear that accepting government money could restrict their religious missions even if the money would help them expand their services.

Speer said Thursday that she hoped the state could “ease some of those tensions” so more centers would be encouraged to apply for this year’s grant.

The Arkansas Pregnancy Network plans to work together to launch a “statewide telehealth initiative” before the end of the year, using some of the state funds to get it off the ground, Speer said.

The initiative will primarily be a hotline run by registered nurses to help pregnant Arkansans with whatever they need, alongside a coordinated marketing plan “to let women know that they can talk to a medical professional before they make any decisions about ordering a pill or crossing a state line,” Speer said.