Arkansas was among eight states and Puerto Rico that received an F for its high rates of preterm births in an annual March of Dimes report released Thursday, with Arkansas’ rate in 2023 rising to its highest level in at least 11 years.
The report, citing data from the Centers for Disease Control and Prevention’s National Center for Health Statistics, found that Arkansas’ preterm birth rate has been mostly increasing since 2013, going from 10% that year to 11.8% in 2022 and 12.1% in 2023. The lowest rate, 10%, over that period was in 2014.
Preterm births are defined as babies born before 37 weeks of pregnancy.
In 2023, Arkansas ranked No. 46 out of the 50 states, Washington, D.C., and Puerto Rico, according to the report.
States with rates of 11.5% or higher were given an F grade. Vermont was the only state to receive an A, indicating a preterm birth rate less than or equal to 7.7%.
Mississippi’s preterm birth rate of 15% was the country’s highest. Also receiving F grades were Louisiana, West Virginia, Alabama, South Dakota, Georgia, South Carolina and Puerto Rico.
Nationally, the rate of preterm births in 2023 was 10.4%, earning the country as a whole a D for the third year in a row.
“In Arkansas, rates of inadequate prenatal care persist,” the March of Dimes said in a news release accompanying the report. “Individuals without prenatal care face preterm birth rates nearly 9% higher than those receiving adequate care, emphasizing the critical importance of early support.”
Camille Richoux, health policy director for Arkansas Advocates for Children and Families, said Arkansas’ score should raise alarms.
“We didn’t even do OK. Like, we didn’t get a C,” Richoux said. “It just shows that there are things that we are leaving on the table. There are policies that we need to be urgently adopting and looking into.”
Policies highlighted in the report that the state has not adopted included extending postpartum Medicaid coverage from 60 days to one year, providing Medicaid reimbursement for doulas, requiring employers to offer paid family leave and licensing certified midwives.
Richoux said that the lack of those supports and the state’s near total abortion ban create barriers that make it more difficult to be healthy at every stage of pregnancy.
“States that are doing better have more flexibility around pregnancy related care. … It needs to be a really proactive approach,” she said.
The report found 19.2% of women in Arkansas who gave birth in 2023 received inadequate prenatal care, defined as initiating care in the fifth month or later of a pregnancy or receiving fewer than half of the appropriate number of visits for the infant’s gestational age.
Richoux said one factor that contributes to inadequate care is the lack of access across the state.
“Arkansas is a really rural state,” Richoux said “One of the most common problems that is highlighted for prenatal care is transportation. It is a huge problem, and it’s not an easy problem to solve.”
In another report from the March of Dimes released in September, 38 — or 50.7% — of Arkansas’ 75 counties were classified as “maternity care deserts,” meaning they had no hospital or birth center offering obstetric care and no obstetric care providers.
That report noted that 15.9% of women in the state had “no birthing hospital within 30 minutes,” compared to 9.7% of women nationwide.
Richoux said smoking and a lack of proper nutrition are among factors that can increase the risk of preterm births.
“A huge risk factor is maternal stress,” Richoux said. “We need to be doing things that take some of those stressors that contribute to not only preterm birth but contribute to some of those not as great coping mechanisms.”
Providing Medicaid reimbursement for doulas was also a recommendation of a committee created by Gov. Sarah Huckabee Sanders in March to to develop a plan to improve Arkansas’ maternal health outcomes.
Those recommendations also included evaluation of Medicaid rates, increasing telehealth and mobile unit use, reducing transportation barriers, expanding prenatal care in local health units and expanding the number of obstetrics and gynecology residencies.
The committee’s recommendations did not include extending the amount of time the Medicaid program provides postpartum coverage to 12 months, as most other states have done.
Sanders has said postpartum women in Arkansas already have other coverage options through Medicaid or private health insurance, and the state just needs to do a better job of switching them to other forms of coverage when their pregnancy Medicaid coverage ends.
“As a mom, Governor Sanders understands the importance of maternal health, which is why she convened her Strategic Committee on Maternal Health earlier this year, and why her administration is working hard to implement the Committee’s recommendations now and in the upcoming Legislative session,” Sanders spokesperson Sam Dubke said in an email.
According to the CDC, Arkansas’ maternal mortality rate, 38.3 deaths per 100,000 births, in 2018-22 was the fourth-highest, behind Tennessee, Mississippi and Alabama, among states for which a rate could be reliably calculated.
Provisional data from the CDC showed Arkansas also had the country’s third-highest infant mortality rate in 2022, with 7.67 infant deaths per 1,000 births.
My Ly is a Report for America Corps member.
