UAMS Study Finds Mothers Living in Rural Areas or Covered by Medicaid Less Likely to Receive Prenatal Care

LITTLE ROCK — Arkansas mothers who live in rural areas and/or who have a Medicaid-covered birth are less likely to receive early prenatal care or receive an adequate number of prenatal care visits, according to a study published recently by researchers at the University of Arkansas for Medical Sciences (UAMS) Institute for Community Health Innovation.

The study, “Disparities in prenatal care utilization among racial/ethnic and nativity subgroups in the United States,” analyzed prenatal care utilization among women in Arkansas. Researchers found that mothers with a Medicaid-covered birth were more likely to have fewer than the recommended number of prenatal care visits, more likely to initiate prenatal care late, and more likely to have no prenatal visits at all.

Researchers also found that some minority groups — specifically Black and Native Hawaiian/Pacific Islander populations — were more likely to experience late or less than the recommended number of prenatal care visits compared to white mothers.

“We know that early and regular prenatal care greatly increases a woman’s opportunity to have a healthy pregnancy and to deliver a healthy baby,” said Pearl McElfish, director of the UAMS Institute for Community Health Innovation. “Women in Arkansas often experience barriers to receiving that care, including access to transportation and doctors who won’t see them until their Medicaid application is approved. If we’re going to improve maternal health in Arkansas, we have to develop systems that meet women where they are and increase access to prenatal care.”

Researchers analyzed data from the National Center for Health Statistics for live births in Arkansas from 2014-2022. The study suggests maternal health could be improved with changes to the state’s Medicaid, such as the lack of presumptive eligibility for mothers and providers. Presumptive eligibility, if provided, would allow mothers temporary eligibility for covered health services while their Medicaid application is being processed.

“By identifying and understanding these barriers, we can create innovative and sustainable solutions to address disparities in maternal health,” McElfish said. “Our efforts include training more community health workers and doulas and enhancing telehealth options, especially in rural areas where regular access to transportation can be limited.”

Arkansas for several years has ranked poorly among other states for maternal health outcomes. According to the March of Dimes, nearly 20% of Arkansas women receive inadequate prenatal care. In recognition of these maternal and infant health outcomes, Arkansas Gov. Sarah Huckabee-Sanders signed an executive order last March to support mothers, protect babies and improve maternal health (E.O. 24–03), with a specific call to better understand and improve utilization of prenatal care in Arkansas.

The UAMS Institute for Community Health Innovation is addressing the state’s poor maternal health numbers through various initiatives, such as offering individual and group prenatal care in rural communities through mobile health services, studying the effects of digital health services for mothers, and training doulas and perinatal community health workers.

“We are proud to play a key role in addressing Arkansas’ maternal health disparities by strengthening and expanding programs that promote prenatal care access for all women in Arkansas,” McElfish said. “Together with our partners and community members, we are building a future where every woman in Arkansas has the support needed for healthy pregnancies and thriving families.”

To learn more about the institute and its work, visit communityhealth.uams.edu.