HJAR Mar/Apr 2026

42 MAR / APR 2026 I  HEALTHCARE JOURNAL OF ARKANSAS NURSING COLUMN NURSING maternal and newborn health, Arkansas legislators and stakeholders have been placing a greater emphasis on the benefits of midwifery care, culminating in the es- tablishment of Arkansas’ first nurse-mid- wifery program. Midwifery care is associated with higher rates of spontaneous vaginal births, low- er rates of induction, lower preterm birth rates, fewer third- and fourth-degree lac- erations, lower infant mortality rates, and higher breastfeeding rates. Midwifery care is also associated with higher patient satis- faction and lower healthcare costs. States with more favorable laws and regulations regarding midwives tend to have fewer preterm births, lower rates of cesarean de- liveries, and lower infant mortality. Clearly, greater integration of midwifery into the healthcare system inArkansas has the potential to directly impact the mater- nal health outcomes. However, improved maternal health outcomes will not arise solely by increasing the number of certi- fied nurse-midwives (CNMs) in the state. Essential to the integration of midwifery is careful anticipation and implementation of safe, effective interprofessional care models. Interprofessional teams may include some combination or any or all of the fol- lowing: CNMs, obstetricians, family med- icine physicians, maternal-fetal medicine physicians, nurse practitioners, physician assistants, community health workers, and doulas. In order to foster collaboration, and to ensure high quality, seamless care as mid- wifery is scaled up in Arkansas, midwives, physicians, and hospital administration should actively consider how to construct an optimal interprofessional team dynam- ic. The American College of Obstetricians and Gynecologists (ACOG) and the Amer- ican College of Nurse-Midwives (ACNM) — the two professional organizations for ob-gyns and CNMs respectively — devel- oped a project in which researchers ana- lyzed a collection of successful collabora- tive practices. The researchers identified common underlying themes that led to success, thus providing Arkansas with a blueprint. It is now the responsibility of our healthcare system to implement this knowledge for the benefit of women and families across the state. A Blueprint for Integrating Midwifery Through Collaboration Five themes emerged from the ACOG/ ACNM Essential Components of Success- ful Collaboration project. For midwifery to thrive as a part of the solution to the ma- ternal healthcare crisis in Arkansas, all five themes must be addressed in current and future interprofessional practices. FOR more than a decade, clinicians, poli- cymakers, community partners, and phil- anthropic organizations in Arkansas have worked to confront persistent inequities in maternal healthcare. Despite national attention, adverse maternal and newborn outcomes in Arkansas remain widespread and the state continues to report the high- est rates of maternal morbidity and mor- tality in the United States. Recently, state legislators and others have promoted mid- wifery as a tool to reverse this trend. Facing the Numbers: Why Arkansas Is Looking to Midwifery For several key indicators of mater- nal and newborn health, Arkansas ranks among the worst-performing states with a preterm birth rate of 11.78%, a low-birth- weight rate of 9.3%, and an infant mortal- ity rate of 7.67 deaths per 1,000 live births. Limited access to maternity services ex- acerbates these outcomes. In 2021, nearly half of Arkansas counties (45.3%) were classified as maternity care deserts — areas lacking both obstetric providers and facil- ities offering obstetric services — while an additional 18.7% of counties had only low or moderate access to care. Collectively, these gaps leave an estimated 91,915 wom- en of reproductive age inArkansas without local access to obstetric care. As part of the state’s efforts to improve ADVANCING MIDWIFERY CARE IN ARKANSAS