HJAR Nov/Dec 2024

HEALTHCARE JOURNAL OF ARKANSAS I  NOV / DEC 2024 47 Zenobia Harris, DNP, MPH, RNP Executive Director Arkansas Birthing Project ty health task force comprised of a diverse group of stakeholders who recommend- ed many critical actions that need to take place, including expanding access to ma- ternity care using telehealth and mobile health units and local health departments as sources of local maternity care as well as establishing policies that will allow Medicaid — which pays for over 40% of all births in Arkansas — to reimburse for doula and community health worker ser- vices for pregnant women. Other import- ant recommendations that come from the task force include the following: enhancing physician/provider obstetrical care edu- cation opportunities; implicit bias training to assist in developing trauma-informed strategies to help improve the care deliv- ered to patients identified as “difficult to serve”; and developing an ongoing wom- en’s healthcare campaign across Arkansas to heighten awareness of available health resources and services for women and teens. Actions are taking place across the state to address the need for interventions to improve maternal health. Many outreach and home visiting programs are being established by hospitals and other care providers to reach pregnant and parenting women across the state. A maternal death review board has been working to identify and develop strategies to prevent recur- rent deaths from identified causes. Federal agencies, including the U.S. Department of Health and Human Services, support a maternal health community of practice activities and work group sponsored by UAMS and the Arkansas Department of Health, which is focused on bringing to- gether multiple maternal health partners in the effort to address the needs of this vulnerable population. The Doula Alliance of Arkansas has been formed to unite dou- las and standardize the understanding of doula practice in Arkansas. Public health awareness and promotion groups like AIM (Arkansans for Improving Maternal Health) and the Arkansas Birthing Project spread the word about our consolidated need for the inclusion of all maternal and infant health providers and activists in our state in this issue. Across the state, we must continue to work collaboratively and supportively to bring an end to the maternal health crisis. We have the resources, knowledge, and the political will to improve social and health conditions and birth outcomes for all pregnant women in Arkansas. n REFERENCES 1 Bond, R.; Bello, N.; Ansong, A.; et al. “Public health and system approach in eliminating dis- parities in hypertensive disorders and cardio- vascular outcomes in non-Hispanic Black wom- en across the pregnancy life course.” American Heart Journal Plus 46 (October 2024):100445. https://doi.org/10.1016/j.ahjo.2024.100445 2 Aziz, A.; Gyamfifi-Bannerman, C.; Siddiq, Z.; et al. “Maternal outcomes by race during postpar- tum readmissions.” American Journal of Obstet- rics and Gynecology 220, No. 5 (Feb. 17, 2019): 484.e1-484.e10. DOI: 10.1016/j.ajog.2019.02.016 3 Daley, G.Q.; Barabino, G.A.; Aiijola, O.A.; et al. “COVID Highlights Another Crisis: Lack of Black Physicians and Scientists.” Med 2, Issue 1 (June 24, 2020): 2-3. PMID: 32838358 4 U.S. Department of Health and Human Services. “Healthy Women, Healthy Pregnancies, Healthy Futures: Action Plan Ito improve Maternal Health in America.” Accessed September 2024. https:// aspe.hhs.gov/sites/default/files/private/aspe- files/264076/healthy-women-healthy-pregnan- cies-healthy-future-action-plan_0.pdf 5 National Commission to Address Racism in Nursing. “Summary Report: Listening Sessions on Racism in Nursing.” June 2021. https://www. nursingworld.org/~49be5d/globalassets/prac- ticeandpolicy/workforce/commission-to-ad- dress-racism/final-racism-in-nursing-listen- ing-session-report-june-2021.pdf 6 Kindelan, K. “Maternal and infant care in ‘cri- sis’ in US, new report finds.” ABC News, Nov. 16, 2023. https://abcnews.go.com/GMA/Wellness/ us-earns-grade-preterm-birth-maternal-infant- care/story?id=104909605 7 American Medical Association. “AMA adopts guidelines that confront systemic racism in medicine.” Press release, June 15, 2021. https:// www.ama-assn.org/press-center/press-releases/ ama-adopts-guidelines-confront-systemic-rac- ism-medicine 8 Lavazza-Mourey, R.J.; Besser, R.E.; Williams, D.R. “Understanding and Mitigating Health Inequi- ties — Past, Current, and Future Directions.” New England Journal of Medicine 384, No. 18 (May 1, 2021). DOI: 10.1056/NEJMp2008628 9 Lister, Rolanda L, Drake, Wonder, Scott, Bald- win H. and Graves, Cornelia. (2019). Black Ma- ternal Mortality-The Elephant in the Room. 2019. World J Gynecology Women’s Health. 2019; 3(1): 10.33552/wjgwh.2019.03.000555. Pub- lished online 2019 Nov 22. Doi: 10.33552/wjg- wh.2019.03.000555. 10 Morton, C.H.; VanOtterloo, L.R.; Seacrist, M.J.; Main, E.K. “Translating Maternal Mortality Review into Quality Improvement Opportunities in Re- sponse to Pregnancy-Related Deaths in Califor- nia.” Journal of Obstetric, Gynecologic, and Neo- natal Nursing 48, No. 3 (May 2019): 252-262. DOI: 10.1016/j.jogn.2019.03.003 11 Kienlen, A. “UAMS receives $2.4 million federal grant for reducing high rates of Arkansas ma- ternal, infant deaths.” Microsoft Start, accessed Sept. 26, 2024. https://www.msn.com/en-us/ health/other/uams-receives-24-million-federal- grant-for-reducing-high-rates-of-arkansas-ma- ternal-infant-deaths/ar-AA1qJxBC Zenobia Harris holds a Bachelor of Science in nursing from the University ofArkansas for Medical Sciences College of Nursing, a Master of Public Health from the University of Alabama at BirminghamSchool of Public Health,and a Doctor of Nursing Practice from the University of Tennessee Health Science Center College of Nursing.Zenobia is anARNAmember who also serves as executive director of the Arkansas Birthing Project.She co-chairs theArkansasMaternal Health Community of Practice Committee sponsored by UAMS and the Arkansas Department of Health. She also served on the outreach subcommittee of Governor Sanders’ maternal health advisory com- mittee. In addition to her work in Arkansas, Zenobia serves as president of the national board of directors of Birthing Project USA, as well as diversity repre- sentative of the board of the Association of Public Health Nurses.