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HEALTH

Arkansas' Maternal Health Crisis: What You Need to Know Before Giving Birth in Arkansas

Dec 1, 2023

Ebony Harding-Kendrick of Kulture Kolumn


A CDC report compiling data from 2018 to 2021 shows Arkansas recorded the highest maternal mortality rate in the nation. Further, a study completed in Arkansas found that Black and Brown women in Arkansas are 2.1 times more likely to die from pregnancy-related causes. Women that look like Rubi Acevedo.


Rubi Acevedo is a Birth and Postpartum Doula trainee with the Ujima Maternity Network and will be the first doula in the group to offer services to the Hispanic community. Acevedo tells me that her negative experience with prenatal care providers in Arkansas pushed her to want to help other women in her community, many of whom face language barriers and unfamiliar birth practices.


“I wanted to do things differently on my third birth.”


Rubi went on to explain that she had never gone into labor on her own. Her doctor has always induced her labor, with her two prior deliveries. She admits she went along with it initially as an 18-year-old expectant mom because she didn’t know any better. But after receiving birthing support from Ujima she decided to take control of her pregnancy journey and she says that’s when things took an unexpected turn with her doctor.


“I took him my birth plan, he immediately started crossing things out. You know, you can’t walk around the room, you can’t take a shower, your boyfriend can’t cut the umbilical cord, you know, I get paid to catch the baby your boyfriend can’t be near you or the baby because that’s what I get paid to do” says, Acevedo.



She said tensions continued to rise the closer she got to her due date, with the doctor becoming so insistent on scheduling an induction in her 39th week of pregnancy that she ended her relationship with him and began planning to have a home birth with assistance from Ujima Maternity Network. Rubi had a safe and successful delivery at home on her terms.


Rubi was well prepared for her birthing journey, but many women across the nation and this state often are not. That’s why it’s time to ring the alarm.


A repoms that people dying in the U.S. from pregnancy-related causes have more than doubled in the last 20 years. National publications like USA Today and National Public Radio (NPR) penned pieces in attempts to center the world’s attention on this issue impacting thousands of women across the country.


I sought to learn the impacts closer to home and reached out to The Arkansas Center for Health Improvement (ACHI). The entity shared that Arkansas has the highest maternal mortality in the nation. But right now, in Arkansas, the numbers are far worse.



Reporting published by KUAR highlights that in Arkansas, there are about 45 pregnancy-related deaths per 100,000 births. That’s according to Every Mother Counts, a nonprofit that works to improve access to maternity care. For perspective, the U.S. as a whole has about 30 pregnancy-related deaths per 100,000 births.


Additionally, Arkansas is one of a handful of states that has not extended critical postpartum Medicaid coverage to Arkansas mothers. Coverage currently ends just 60 days after birth. One is left to ask, what is being done to save the lives of Arkansas women and mothers?



In 2019, the Arkansas General Assembly moved to take action creating the Arkansas Maternal Mortality Review Committee (AMMRC), the entity composed of Arkansas physicians, maternal health professionals, mental health professionals, medical examiners, nurses, anesthesiologists, and educators working to identify the factors that lead to poor maternal health outcomes and to make recommendations that will decrease maternal mortality and morbidity. Life-saving work needs to be done now. Dr. Gloria Richard-Davis says Arkansas is in trouble.

“I think it’s a crisis. Anytime we have a maternal death, and so what we know about maternal health in this country. For a developed country, we have some of the worst statistics in the world. And Arkansas as a state. Is leading in not a good way.”

Richard-Davis is the Executive Director of the University of Arkansas for Medical Sciences (UAMS) Office of Diversity, Equity, and Inclusion and a Professor of Reproductive Endocrinology and Infertility with over 30 years of experience as a health care provider. When asked about how Arkansas got to such a low point Richard Davis pointed to several contributing factors.

“We have a very unhealthy population statewide, and so, many of our pregnant women. Have comorbid conditions when they get pregnant. We don’t do a good enough job at pre-conception counseling where we could help to optimize their health, or at least better control some of the chronic diseases that contribute to morbidity and mortality. And what we’re seeing just nationwide– it’s astounding to me that we’re seeing younger women with–cardiac disease. There was a report I looked at and I almost just dropped to the floor where it said probably 20% of young women in their 20s have underlying cardiac disease, undiagnosed.”

Director of Health Policy for ACHI, Craig Wilson echoed many of Dr. Gloria Richard Davis’ opinions.

“Variation(s) in quality and access to healthcare, underlying chronic conditions, social determinants like access to healthy food and affordable housing that affect health — all of which have been impacted by systemic racism that has shaped the ability to survive and thrive historically. ACHI says their work advocates for guidelines that create healthy outcomes that span the entire pregnancy and beyond. “You want a journey that is intentional, met with sufficient access to prenatal care, has education and supports that are linguistically and culturally appropriate,” says Wilson.

This is an issue that won’t be fixed overnight. It will take many hands, minds, and hearts to make the necessary changes to save the lives of Arkansas women who die pregnancy-related deaths, unnecessarily. One of the chief findings of the Arkansas Maternal Mortality Review Committee is that 91% of Arkansas pregnancy-related deaths were preventable.


A statistic was revealed in a September 2023 report by THV11 journalist, Mackailyn Johnson. In a sit-down conversation with Johnson, she shared her motivation for pursuing this story.

“I mean, as a black woman, it’s just kind of like an unspoken thing where you know that it’s like in a hospital, if you’re pregnant, you might not come out alive.”- Mackailyn Johnson

One of Johnson’s other findings in breaking down Arkansas’ 2022 AMMRC maternal mortality report was that Black and African American women in Arkansas are 2.1 times more likely to die from pregnancy-related causes than white non-Hispanic women.


A baby resting on her mother during a Ujima Maternity Network Community Outreach event in Pine Bluff, Ark. Photo Credit: Ebony Kendrick
A baby resting on her mother during a Ujima Maternity Network Community Outreach event in Pine Bluff, Ark. Photo Credit: Ebony Kendrick

Dr. Richard-Davis sits on the AMMRC working to end Arkansas’ Maternal Health and pointed to several factors for such poor health outcomes for Arkansans. She explains, “We have a shortage in the state of obstetrician-gynecologists, as well as a shortage of delivering hospitals. So, access is constrained in many cases. We have telehealth where we have bridged some of the gaps, but really the biggest gap that telehealth bridges is high high-risk O.B. consultations. It doesn’t really bridge that low-risk access, right? Because if you have to travel for three or four hours for a visit. Many patients either don’t have transportation or they can’t afford to be off work. That would be an entire day.” She continues, “for a lot of our patients and we do have family medicine docs in the state that have a wealth of experience with delivery, but that population is aging out.”


The gaps seem hard to fill, but there is a burgeoning movement led by Black and Brown women who are on a mission, to save the lives of their sisters. Enter Ujima Maternity Network, a non-profit co-founded by Nicolle Fletcher and Sarita Hendrix built to take on Arkansas’ maternal health crisis. The organization established in 2018 on the third day of Kwanzaa adopts the principle of doing collective work to build and maintain a healthy community. Fletcher explains the collective’s approach to their work.

“To be the solution or part of the solution. So, we understand that this work is not going to get better from just one entity changing right? It’s going to take all of us working collectively, every area or every aspect that touches material, healthcare working in collaboration.”

Ujima provides connections to doulas who come alongside doctors and parents to offer non-medical emotional, physical, and informational support as well as staunch advocacy for the mom during preconception, pregnancy, labor, and postpartum life.


In the event a mom wants someone other than a doctor to provide maternal healthcare the Ujima Network can link moms with licensed midwives to assist in delivery especially in places around the state with barriers to health care. The love, protection, and support provided by the organization sometimes give way to the rise of more birth support professionals, like Rubi Acevedo, and many more passionate women.

“It’s an awareness that you matter, your birth matters and you’re not another number. Creating space for black mothers, specifically brown mothers as well to be seen to be heard, to be understood, to be valued, your experience matters,” says Fletcher.

In separate interviews, both Nicolle Fletcher and Dr. Gloria Richard Davis agreed that a “team-focused” approach is the best means of survival for Arkansas women. Whether your birth support team consists of you, your family, and a doctor, or a trio comprised of the mother, doctor midwife, and a doula you can’t go wrong with help.


For birth support and pregnancy education provided by UAMS, visit https://patientslearn.uams.edu/patient-resources/pregnancy-childbirth. To learn more about the Ujima Maternity Network and the doula and midwife services they offer, visit https://www.ujimamaternitynetwork.org/doula-training.html. To follow both National & Arkansas progress in solving the Maternal Health Crisis, follow this contributing writer at @ebbiekendricktv on X (formally known as Twitter).


Ujima Maternity Network Co-founder Nicolle Fletcher speaks passionately about saving the lives of Black and Brown women inside her Conway, Ark office. Photo Credit: Ebony Kendrick. Ujima Maternity Network Co-founder Nicolle Fletcher speaks passionately about saving the lives of Black and Brown women inside her Conway, Ark office. Photo Credit: Ebony Kendrick.
Ujima Maternity Network Co-founder Nicolle Fletcher speaks passionately about saving the lives of Black and Brown women inside her Conway, Ark office. Photo Credit: Ebony Kendrick. Ujima Maternity Network Co-founder Nicolle Fletcher speaks passionately about saving the lives of Black and Brown women inside her Conway, Ark office. Photo Credit: Ebony Kendrick.

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