HJAR Mar/Apr 2026

HEALTHCARE JOURNAL OF ARKANSAS I  MAR / APR 2026 43 Samantha Crouch, DNP, CNM, FACNM, IBCLC University of Arkansas for Medical Sciences Theme 1: Impetus for New Collaboration This theme underscores the importance of a shared motivation, whether to im- prove outcomes, reduce cost, or explore novel ways to provide care. SinceArkansas is unified in the desire to improve maternal outcomes, this theme poses little challenge to new interprofessional teams. Theme 2: Basic Foundations of Collaborative Care This theme addresses the need for func- tional building blocks of collaboration, both relationally and systemically. Key building blocks could include practices of reciprocal consultation, seamless referral processes, and a financial structure that di- minishes competition for clients and care processes, among others. While existing practices currently work toward improved reciprocal consultation and referrals, there is significant opportunity for growth. At a systems level, referral processes could be improved between hospital and commu- nity-based providers in Arkansas. Addi- tionally, continued exploration of financial structures to optimize accessibility to care while minimizing competition between providers is warranted. Theme 3: Commitment to Successful Partnership This theme stresses that mutual respect and trust lead to effective partnerships and that it is essential that both physicians and midwives are given leadership opportuni- ties, such as appointment to medical staff. Aspects of this theme are not currently universally represented across healthcare organizations in Arkansas, but do repre- sent tangible, readily attainable changes that will optimize care teams. Theme 4: Care integration This theme puts the focus on the care provided at the intersection of midwife- ry philosophy and the medical model. As new practices are developed, Theme 4 will provide opportunities for providers to creatively consider how each of their trainings, experiences, and skill sets can be melded into improved models. Theme 5: Health Professions Education in an Interprofessional Practice Environment Researchers from this project noted that, “When education occurred in an in- terprofessional setting, residents valued midwifery teachers for their approach to normal birth and supportive teaching style.” Arkansas is fortunate to house its first CNM program at University of Arkan- sas for Medical Sciences (UAMS), under the same roof as established, respected ob-gyn, family medicine, and nurse practi- tioner programs. The opportunity to train CNMs alongside physician residents and other healthcare providers, while incor- porating intentional interprofessional ed- ucation, will be fundamental in forecasting interprofessional success. Turning Evidence Into Action The time is right for midwifery to flour- ish in Arkansas. With CNMs, there is an opportunity to leverage an underutilized, evidence-based model of care that will simultaneously improve outcomes for mothers and infants statewide. However, implementation will require a whole sys- tem approach. Arkansas has made great strides in addressing themes of successful collaboration, but further effort and inten- tional policy change are warranted to en- sure the success of midwifery in the state. Equitable leadership opportunities, inte- grated models and philosophies of care, and reciprocal referral and collaboration represent essential and attainable efforts in developing and sustaining interprofes- sional models with midwives. n REFERENCES National Vital Statistics System CDC WONDER Online Database, National Center for Health Statistics, Centers for Disease Control and Prevention, 2023, https://wonder.cdc.gov/ natality-expanded-current.html, accessed November 3, 2023. “Statistics by State: Arkansas,” National Center for Health Statistics, 2025, https://www.cdc.gov/ nchs/state-stats/states/ar.html. “2024 March of Dimes Report Card for Arkansas,“ March of Dimes, 2024, https://www. marchofdimes.org/peristats/reports/arkansas/ report-card, accessed September 2025. “Midwifery: Evidence-Based Practice: A Summary of Research on Midwifery Practice in the United States,” American College of Nurse- Midwives, revised April 2012, https://midwife. org/wp-content/uploads/2024/10/Midwifery- Evidence-Based-Practice.pdf. M. R. Altman, et al., “The Cost of Nurse-Midwifery Care: Use of Interventions, Resources, and Associated Costs in the Hospital Setting,” Women’s Health Issues 27, no. 4 (2017): 434–40. S. Vedam, et al., “Mapping Integration of Midwives Across the United States: Impact on Access, Equity, and Outcomes,” PloS One 13, no. 2 (2018): e0192523. “Statement of Policy: Joint Statement of Practice Relations Between ACNM and ACOG,” American College of Obstetricians and Gynecologists, 2022, https://www.acog.org/clinical-information/ policy-and-position-statements/statements- of-policy/2018/joint-statement-of-practice- relations-between-ob-gyns-and-cnms. M. D. Avery, et al., “Essential Components of Successful Collaborative Maternity Care Models: The ACOG-ACNM Project,” Obstetrics and Gynecology Clinics of North America 39, no. 3 (2012): 423–34, https://doi.org/10.1016/j. ogc.2012.05.010. Samantha Crouch is a certified nurse-midwife, Fel- low of theAmerican College of Nurse-Midwives,and International Board-Certified Lactation Consultant. She earned undergraduate degrees in nursing and Spanish from the University ofArkansas and amaster of nursing and doctor of nursing practice at Oregon Health & Science University.She currently serves as program director for the nurse-midwifery program and as an assistant professor in the College of Nurs- ing at UAMS and provides outpatient gynecologic and reproductive healthcare at UAMS Northwest.