Rural Living Presents Challenges

Amanda Sellers of Fox has 12 children, and is expecting numbers 13 and 14. She is well aware of the challenges that face expectant mothers in Stone County. She has traveled to Batesville, Little Rock, and once planned to travel as far as Missouri to give birth. She has spent hours upon hours on the road going to prenatal visits.

She has also experienced the other side of giving birth: an unintended, but very easy, home birth where her husband caught the baby, and giving birth in Virginia, where the laws are more amenable to midwives and home births, especially for expectant mothers like Sellers, who are attempting VBAC (vaginal birth after C-section).

“One of my apprehensions, when moving back to Arkansas, was if we continue to grow our family, I am going to have to figure this out again,” Sellers says.

Sellers knows very well what the March of Dimes is talking about when they labeled Stone County a “maternal care desert” in a nationwide report on access to maternal care earlier this month.

She also well knows some of the moves that Arkansas has made to address the problem. For this pregnancy, she has been able to attend prenatal visits in Mountain View, at the Stone County Health Unit.

The March of Dimes report, “Nowhere to Go: Maternity Care Deserts Across the U.S.,” released Aug. 11, calls attention to the growing problem across America posed by maternity care deserts, but the problem has been studied within Arkansas more thoroughly by organizations such as the Arkansas Center for Healthcare Improvement.

ACHI looked at data from hospital births to compare the location where babies were born to the home address listed for the mother, says Jennifer Wessel, Interim Director of Health Policy at ACHI. In doing so, they determined that the median travel time for a Stone County mother to reach a labor and delivery unit is 63 minutes. That’s well beyond the 45-minute window that the March of Dimes study uses to determine a maternity care desert.

Both organizations have also examined access to prenatal and post-natal care around the state. Stone County scored low in that respect on both reports, although the ACHI report, which draws from more recent data, indicates that there is some limited access to prenatal care.

Part of that improvement may be due to an initiative announced by Gov. Sarah Sanders in May of this year to connect expectant mothers with resources that are already available, such as maternal care available at local health departments.

The “Claim Your Care” initiative includes a website, claimyourcarear.com, which is a portal for expectant mothers, or for those hoping to become pregnant, to find care in their area.

Arkansas Surgeon General Kay Chandler says, “Obviously, in the local health units, there’s not providers who deliver babies, but they do provide excellent prenatal care.” Chandler said that Stone County is one of the counties that offers regular prenatal care at the local health unit.

Mary Ann Long, administrator for the Stone County Health Unit, said that prenatal care is available on Mondays, and that appointments are available by calling the health unit at 870-269-3308.

There are other recent changes to state law that policy makers hope will expand opportunities for women to have healthy pregnancies and deliveries, and receive adequate care postpartum. The Healthy Moms, Healthy Babies Act passed during the 2025 legislative session implemented some of the suggestions made in the March of Dimes study, including expanding the types of care that are reimbursed by Medicaid to include licensed doulas and community health workers. The act fast-tracks Medicaid for pregnant women instead of waiting 45 days for standard approval, and expands coverage to include remote monitoring of things like blood pressure and glucose levels.

There is still much to be done. Many health policy advocates would like to see the state provide pregnancy-related Medicaid coverage for a full 12 months, as many other states do, rather than the 60 days that the state now provides. Rural hospitals continue to see shortfalls in many parts of the state, and historically, labor and delivery units have been among the first things to close in small hospitals.

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This article is the first in a series that seeks to put a face on the problem of maternal care deserts, and specifically the challenges faced by moms in Stone County. To share your experiences, please contact reporter Michelle Nowlin at 501-517-0962 (text or call), or e-mail mposeyphoto@gmail.com.