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Hanging by a Thread (Lance Turner Editor’s Note)

2 min read

The maternity business was on my mind last week, and not just because of the cover stories in this issue of Arkansas Business.

My cousin and her husband welcomed twin girls into the world last week, making their 3-year-old daughter a big sister. No pregnancy is without worry, and the surprise of twins added a level of complexity. But from what I gather, my cousin and her girls have, from the beginning of the pregnancy, received good health care that continues beyond delivery.

They are also fortunate to live near a hospital with a maternity ward, a luxury that many Arkansans do not have, according to reports this week by Lara Farrar and Mark Friedman.

Their work shows what health care providers and policy leaders have been confronting for awhile now — growing areas of the state where maternity wards and services for expectant mothers are scarce to nonexistent.

One problem is that operating a labor and delivery unit is expensive, and many rural hospitals simply cannot afford it. Bradley County Medical Center CEO Leslie Huitt said that her labor and delivery business, in extreme southeast Arkansas, loses $1 million a year. “It is hanging on by a thread,” she said. But it stays open as a service to the community.

Arkansas has high levels of poverty, and almost half of its births are paid for by Medicaid, the public health insurance program for poor Americans. But Medicaid has not kept pace with rising costs. In fact,  Medicaid rates haven’t risen since 2007, and there are no plans to raise them anytime soon.

That means in hospitals like Baxter Health in Mountain Home, in rural north-central Arkansas, labor and delivery loses money on every Medicaid patient who gives birth. And if Baxter Health ever closed its maternity ward, Mountain Home residents would face at least an hour’s drive to the next nearest delivery unit. And many Baxter patients already drive farther than that.

Fewer maternity wards and related services exacerbate a tough situation for expectant mothers. As Farrar reports, Arkansas’ rates of infant and maternal mortality are already higher than the national average. And a stunning percentage of pregnancy-related deaths in 2018 and 2019 in Arkansas — 91% — are considered by the state’s Arkansas Maternal Mortality Review Committee to have been “potentially preventable.”

We hear a lot in Arkansas about making the state more competitive for business growth and outside investment. And those things are important.

But imagine how we could improve the health of our mothers and babies if we applied the same emphasis to them. Improving maternal and infant health would, in itself, be a compelling economic development hook.

“Arkansas, the best state in the country to have a baby.” Give that some thought.

Lance Turner is the editor of Arkansas Business.
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