HJAR Jul/Aug 2024

HEALTHCARE JOURNAL OF ARKANSAS I  JUL / AUG 2024 35 Joseph W. Thompson, MD, MPH President and Chief Executive Officer Arkansas Center for Health Improvement found that many teen mothers in the state get pregnant again after an interval of less than the recommended 18months following a previous delivery. Among those who had a first birth between 2016 and 2018, 24.1% of 19-year-olds, 26.6% of 18-year-olds, 22.2% of 17-year-olds, 16.8% of 16-year-olds, 12.8% of 15-year-olds, 6.0% of 14-year-olds, and 4.8% of those 13 or younger conceived a second pregnancy less than 18 months after giv- ing birth. 5 Long-acting reversible contraceptives Despite the efficacy of long-acting revers- ible contraceptives (LARCs) in preventing unintended and short-interval pregnancies, only 16% of recently pregnant women in Arkansas used these devices in 2021. Nearly a third of pregnancies in Arkansas are un- intended, with even higher rates of unin- tended pregnancies occurring among teens and among women who become pregnant again within the first year after giving birth. LARCs are an available and effective solu- tion to increase intentionality of pregnancy. 6 Birthing hospitals As of February, there were only 35 birth- ing hospitals across Arkansas’ 75 counties. 7 Several facilities have closed their labor and delivery units in recent years, including Ashley County Medical Center in Crossett, Helena Regional Medical Center in Helena- West Helena, Magnolia Regional Medical Center, and Bradley County Medical Center inWarren. The loss of these birthing centers reduces access to maternal health services and increases drive times for moms seeking maternal care. Delivering providers While OB-GYNs perform the vast major- ity of deliveries in the state, family physi- cians, certified midwives and lay midwives play an important role in expanding access to delivery services. 8 AnACHI analysis found that: • Of the 32,439 deliveries that occurred in Arkansas in 2022, 98.7% were per- formed by physicians. • The remaining 1.3% of deliveries were performed by lay midwives, certified midwives, or other healthcare pro- fessionals. The analysis excluded the small number of deliveries performed by non-healthcare professionals. • Of the 347 delivering providers in Ar- kansas in 2022, 88.5%were physicians, 7.2%were lay midwives, 1.7%were cer- tified midwives, and 2.6% were other healthcare professionals. • Of the 307 physicians who performed deliveries in Arkansas in 2022, 81.8% were OB-GYNs, 12.7% were family medicine physicians, and 5.5% were physicians with other or unknown specialties. Alignment of race/ethnicity Alignment of race and ethnicity is as- sociated with improved provider-patient Key risk factors ACHI reviewed data from the Centers for Disease Control and Prevention to identify key points of risk for Arkansas mothers be- fore, during, and after pregnancy. 2 Among other things, the data show that for every 100 newmothers — defined as women who gave birth two to four months before being surveyed — in 2021: • Only 39 took a multivitamin four or more times a week during the month before pregnancy. • Only 49 received a flu shot in the 12 months prior to delivery. • Ten smoked cigarettes during the last three months of pregnancy. • Twenty reported experiencing post- partum depression. Chronic disease prevalence Arkansas women ages 18 to 44 have rates of chronic disease that exceed national aver- ages in multiple categories, including dia- betes (4.2% inArkansas vs. 3.3% nationally), high blood pressure (17% in Arkansas vs. 10.8% nationally), and obesity (40.7% inAr- kansas vs. 31.5% nationally). 3 These condi- tions stress a woman’s body before concep- tion and impact her body’s ability tomanage the stress of pregnancy. Teen births Arkansas has one of the highest teen birth rates in the nation, with 26.5 births per 1,000 teens in 2021, compared to 14 births per 1,000 teens nationally. 4 An ACHI analysis