Copyright Arkansas Online
New legislation in Arkansas is being cited as instrumental in the Community Clinic's new midwifery program, which recently welcomed its first baby. Gov. Sarah Huckabee Sanders issued an executive order in March 2024 establishing the Arkansas Strategic Committee for Maternal Health in Arkansas in an effort to expand maternal health services. The Community Clinic served on a subcommittee of that group and suggested things like the expansion of Medicaid coverage for doulas and community health workers and creating midwifery education programs, according to a news release from the clinic. Lawmakers later approved and Sanders signed the Healthy Moms, Healthy Babies Act into law in February, which aimed to provide more efficient Medicaid enrollment for pregnant women and allowed insurance coverage for doula and midwifery services. After the legislation's passage, the Community Clinic launched its midwifery program alongside Willow Creek Women's Health Hospital in Johnson and Northwest Health in Siloam Springs. That program recently delivered its first baby. "We are overjoyed by the arrival of our program's first little one -- a beautiful new beginning for the family and for Community Clinic," said Judd Semingson, CEO of Community Clinic. "This success reflects what community-centered care, strong partnerships and thoughtful policy can achieve in Arkansas." Candice Killeen, the certified nurse midwife who delivered the baby, said she joined the program in part to help counter a "maternity health care desert" in Siloam Springs, where the labor and delivery unit at the hospital has been closed for about a year. "There hasn't been any maternal care, full spectrum, in Siloam Springs until they created this program and stepped into that gap," Killeen said. "That was a big driving force for me to fill a need in the community." The Community Clinic's midwifery program is in Siloam Springs. Community Clinic encompasses 30 clinic locations across Benton and Washington counties and northeast Oklahoma. Women's health services and prenatal care are among the health care services it provides. Killeen also expressed her hopes for both the future of the program and maternal health in Arkansas. There has been a lot of attention to maternal health care, and most people are aware Arkansas hasn't ranked very high in positive outcomes with maternal health, Killeen said. Research shows midwifery care can help to decrease risk and create more positive outcomes, she added. "This program is a really great example of a lot of the collaboration, whether it's been legislative or throughout the community, where we're coming together and being part of a solution and starting to address these concerns ... and also bringing families more options," Killeen said. Pearl McElfish is the director of the Institute for Community Health Innovation at the University of Arkansas for Medical Sciences and also leads the Maternal Reproductive Community Excellence Health Research Center. "I think moms ... face a lot of barriers, and we too often shift the blame or responsibility (onto) the moms," she said. "And it's really critical these programs and policies are focused on how we meet moms where they are. We don't have enough obstetricians in Arkansas ... but midwives can care for women who are low to moderate risk and really allow physicians to focus on the patients that need them the most, while also spending more time with the women that they're caring for." UAMS is launching a master's level midwifery program next fall. It was created to increase the number of midwives available within the state and general health care systems. There are currently about 20 midwives practicing in the state. Program Director Samantha Crouch believes nurse midwifery is essential to improving maternal care throughout the state and allows for more positive maternal health outcomes. Increasing access to a midwifery model of care is associated with lower rates of C-sections, higher rates of spontaneous vaginal deliveries, higher breastfeeding rates, lower rates of preterm birth and low birth weight infants, and other positive maternal and infant health outcomes, Crouch said. "We aim to impact that access to care and those maternal health outcomes by graduating out these new nurse midwives," she added. McElfish is optimistic for the future of maternal health in Arkansas and the potential for improvement not only here in Arkansas, but nationwide. "My hope, my vision is that partners from around the state come together, putting the pregnant mom at the center, and we are able to really focus on whatever the mom needs more than our own individual services," McElfish said. "Right now we're known for the worst disparities, (but) I think we could be known, in two or three years, for coming up with the most innovative options, programs, research for how to address disparities, and that those can be taken across the nation."
