A new analysis from the March of Dimes finds that almost half of Arkansas’ counties lacked local options to give birth in 2024, a condition the group calls maternity care deserts. The report says 33 of the state’s 75 counties had neither a place to deliver babies nor obstetric physicians, affecting roughly 78,000 girls and women between ages 15 and 44.
Scope of the shortage
The report calculated that nearly 5,000 infants were born to residents of those 33 counties in 2024. It also highlights the state’s broader maternal health challenges: Arkansas has one of the highest maternal mortality rates in the nation, with 38 maternal deaths per 1,000 live births reported between 2018 and 2022 by the independent research center KFF.
| Measure | Figure |
|---|---|
| Counties in Arkansas | 75 |
| Counties classified as maternity care deserts | 33 |
| Women ages 15–44 living in those counties | ~78,000 |
| Babies born to residents of those counties in 2024 | ~5,000 |
| Maternal deaths per 1,000 live births (2018–2022) | 38 |
Causes and policy context
The March of Dimes contends that maternity care deserts are not inevitable but are shaped by policy choices and long-term underinvestment in maternal health infrastructure. The report also factors in rates of uninsured and underinsured residents — a particularly important metric in Arkansas, where about half of births are covered by Medicaid.
State-level policy decisions have drawn national attention. A bipartisan 2025 Arkansas law aimed to expand maternal services within Medicaid, but the state has not taken advantage of the federal option to extend postpartum Medicaid coverage from 60 days to 12 months — a move other states have adopted to improve postpartum outcomes. Advocacy groups say that failure to adopt the extension increases uncertainty about coverage after childbirth.
“Stable health coverage is an important foundation for a healthy pregnancy, which makes the uncertainty surrounding Arkansas’s ARHOME Medicaid expansion particularly concerning,”
That statement came from Camille Richoux, health policy director at Arkansas Advocates for Children and Families, who has repeatedly urged lawmakers to adopt the Medicaid postpartum extension.
Local impact and access barriers
For residents of affected counties, the absence of local labor-and-delivery units and obstetricians means longer travel distances for prenatal appointments and childbirth. The report warns that these conditions can increase risk for poor outcomes by delaying care for complications and limiting access to routine prenatal services.
- Women in maternity care deserts may rely on distant hospitals, birthing centers, or limited local clinics.
- Transportation, work schedules and child care are common practical barriers to accessing distant care.
- Insurance coverage gaps and provider shortages compound the problem.
What officials and advocates say
Medical professionals, community groups and maternal health advocates have been raising alarms about Arkansas’ maternal health metrics for years. The March of Dimes report adds new data to those concerns and frames gaps in access as consequences of policy and investment decisions.
Advocates have pointed to the unfinished business of ensuring stable coverage before, during and after pregnancy. With Medicaid covering a substantial share of births in the state, changes to the ARHOME Medicaid expansion and federal policy decisions leave the future of coverage uncertain for many families.
What this means for Arkansans
The report underscores that residents of many counties face constrained choices for maternity care, which can have long-term effects on maternal and infant health. For policymakers, the findings provide fresh evidence to consider when debating Medicaid policy, rural hospital funding and incentives to recruit obstetric providers to underserved areas.
For families, practical steps include discussing travel plans with health providers early in pregnancy, confirming insurance coverage for potential out-of-county care, and looking for community resources such as transportation assistance or telehealth prenatal options when available.
The March of Dimes report adds urgency to ongoing conversations in Arkansas about how to stem maternal deaths and expand access to care across the state’s rural and urban communities.
