A new report from the March of Dimes highlights significant shortcomings in Arkansas’ maternity care system, with nearly half of the state’s counties classified as “maternity care deserts” in 2024. These areas have no hospitals offering labor and delivery services and no practicing obstetric physicians, leaving an estimated 78,000 girls and women, ages 15 to 44, without nearby options for giving birth.
According to the report, almost 5,000 babies were born that year to residents of the 33 affected counties. Nationally, about one-third of counties are categorized as maternity care deserts, compared to nearly half in Arkansas.
“Maternity care deserts are not naturally occurring, nor are they inevitable,” the March of Dimes wrote in its findings. “They are the result of policy decisions and longstanding underinvestment in maternity care infrastructure.”
Arkansas has one of the highest maternal mortality rates in the nation, ranking fourth with 38 maternal deaths per 1,000 live births between 2018 and 2022, according to data from the health research organization KFF. Medicaid covers roughly half of the state’s births, but recent federal changes have created uncertainty about the future of Medicaid coverage in Arkansas. A bipartisan law passed in 2025 aimed to expand maternal health services under Medicaid. However, Arkansas is the only state that hasn’t adopted a federal option to extend postpartum Medicaid eligibility from 60 days to 12 months.
Advocacy groups, such as Arkansas Advocates for Children and Families, are calling on state officials to strengthen health coverage for mothers before, during, and after pregnancy. Camille Richoux, the group’s health policy director, expressed concern over instability in Arkansas’s Medicaid expansion program, ARHOME, which could disrupt coverage for over 200,000 residents. Recent federal changes also include significant cuts to rural Medicaid funding under the One Big Beautiful Bill Act, which might risk additional hospital or maternity ward closures, particularly in rural areas.
Between 2020 and 2024, six Arkansas hospitals closed their labor and delivery units. Two more closures were reported this year, leaving Ouachita County without a delivering hospital and increasing the distances some residents must travel to seek care. Only 22 of Arkansas’ 75 counties still have labor and delivery services, the report found.
On average, Arkansans faced a travel time of 22 minutes to reach the nearest facility offering childbirth in 2024. The Arkansas Center for Health Improvement reported that nearly 30% of pregnant women in the state traveled over 30 minutes, and 8% traveled more than an hour, to access maternity care. Experts note these delays can raise the risks of complications for mothers and newborns.
Nationwide, 96 labor and delivery units closed between January 2024 and May 2026, with nearly two-thirds of closures happening in rural hospitals. Hospital administrators have cited low insurance reimbursement rates and declining birth rates as key factors contributing to these closures.
The report also examined insurance coverage among women of childbearing age. In 2024, about 83,000 Arkansas women between the ages of 19 and 54 were uninsured. The combination of high uninsured rates and lack of maternity care options was especially prevalent in western counties.
Arkansas has taken some steps to expand services, including the Healthy Moms, Healthy Babies Act of 2025, which provides presumptive Medicaid eligibility to pregnant women, creates funding for doula and community health worker services, and ensures Medicaid coverage for certain pregnancy-related care. However, implementation challenges remain. For example, a provision requiring Medicaid and private insurers to cover doula care had not been enacted by July 2026, despite being required by law.
Ongoing advocacy efforts have spotlighted the need to address maternity care deserts and improve access to healthcare services for Arkansas families.