By TESS VRBIN | Arkansas Advocate
Nashville resident Emily Young delivered her first child nearly two hours away from home in 2023 and will do the same with her second in December.
The closest in-state labor and delivery unit to Young’s home is Hot Springs’ CHI St. Vincent hospital. Even routine prenatal medical appointments required Young to take time off work during her first pregnancy, she said, but this time CHI’s AR MOMS system of mobile health clinics has alleviated the problem.
“It has made a big impact for us financially, because it saves us from having to be out of gas money, out of time,” said Young, a Medicaid beneficiary and her household’s only income earner.
The AR MOMS mobile health clinics help fill a growing need in rural Southwest Arkansas, which has few maternal health care providers and only five delivery hospitals: two in Hot Springs, one in Camden, one in Arkadelphia and one in Mena. Texarkana’s hospital stopped delivering babies after a new owner bought the facility last year, and the hospital on the Texas side of the state line does not accept Arkansas Medicaid.
AR MOMS has a presence in eight small cities: Nashville, De Queen, Mt. Ida, Glenwood, Magnolia, Amity, Fordyce and Murfreesboro. The program serves pregnant residents of Montgomery, Polk, Pike, Howard, Sevier, Hot Spring, Clark, Dallas, Calhoun, Ouachita and Columbia counties.
“With our mobile clinics, moms can drive 30 minutes or five minutes and receive their prenatal care much earlier, which is the goal: to see all the moms in the first trimester and identify any needs that they have,” such as housing and nutrition benefits, transportation assistance and perinatal mental health care, registered nurse and AR MOMS director Dawne Sokora said.
The program launched in September 2023 and is funded by a $4 million federal rural maternity obstetrics grant from the U.S. Department of Health and Human Services.
Like Young, Brittney Santos has relied on Hot Springs for labor and delivery services, but when she had her first child in 2010, she lived in Arkadelphia and gave birth there. Santos now lives in Daisy, a Pike County town of fewer than 100 people, and visited AR MOMS’ Glenwood location during her high-risk pregnancy last year.
“They were sweethearts,” Santos said. “They tried to take care of me the best they could…but there was only so much they could do for me.”
When Santos sought help for early cervical dilation during her pregnancy last year, she sought help from the AR MOMS clinics in Glenwood and De Queen, but neither could help. They directed her to Hot Springs.
Seven months postpartum, Santos said she is still experiencing pain and mobility issues but has not received the care she needs because Hot Springs providers are “so busy they can’t help you after you have the baby.”
For Young, the mobile clinics provide “peace of mind” due to Southwest Arkansas’ shortage of providers and long drives to regular clinics and hospitals. Young hasn’t had problems during her second pregnancy, she said, but providers at Nashville’s AR MOMS clinic have given her medication to reduce her risk of developing preeclampsia, which she had during her first pregnancy.
“They call, they check on you…They’re always offering a helping hand,” Young said. “Other times, I’ve had experiences where it’s not been like that, where they just want you in and out real quick.”
Provider reimbursements
The future of the clinics is uncertain, however. The program is expected to end in August 2026, but Sokora said she hopes the federal government will extend the program because she plans to have excess funds as a result of being “very frugal.”
Sokora said she previously stretched a $690,000 federal grant for a three-year maternal health program into five years, but she acknowledged that meeting pregnant rural Arkansans’ needs takes a lot more than frugality.
Since President Donald Trump took office in January, his administration has issued a series of executive orders and other guidance pausing, halting or throwing into uncertainty a wide range of federal grants. Sokora said she’s not worried about losing the grant sustaining AR MOMS with one year left, but she worries she won’t be allowed to “roll over excess funds” for the program’s final year.
“The question is going to be: Will we be able to do as much for our moms as far as social determinants of health and being able to facilitate transportation and those sorts of things for them?” Sokora said. “I believe that we will be able to sustain the grant past [2026], but it will be on a much smaller scale.”
A new state law will be “the only reason” AR MOMS is likely to last beyond the grant’s expiration date, Sokora said. The Healthy Moms, Healthy Babies Act separated the billing rates for labor and delivery and allowed health care providers throughout Arkansas to bill for community health workers, doulas and perinatal mental health specialists.
The federal Centers for Medicare and Medicaid Services authorized a 70% increase in Arkansas’ maximum reimbursement rate for obstetrical care “to include prenatal, delivery and postpartum care,” according to a rule authorized by state lawmakers last month in order for the Healthy Moms, Healthy Babies Act to go into effect.
The Healthy Moms, Healthy Babies Act passed the Legislature with bipartisan support, but some lawmakers took issue with lowering the statute of limitations for legal actions against alleged medical injuries during birth from children’s 11th birthday to their fifth.
Only 33 hospitals in 22 of Arkansas’ 75 counties have labor and delivery units, and six maternity wards have closed since 2020. The medical malpractice insurance required to cover the previous 11-year statute of limitations contributed to the closures and fosters the state’s difficulty recruiting and retaining obstetrician-gynecologists, said Sen. Missy Irvin, R-Mountain View, the primary Senate sponsor of the Healthy Moms, Healthy Babies Act.
Maternal health professionals are “not going to make a living” in rural areas without additional policy changes, Sokora said.
“In these small towns where 80% of your patients are on Medicaid, and the reimbursement is so low, I think the reimbursement going up will help just as much as the malpractice [insurance] going down,” Sokora said.
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