If a woman gives birth in an Arkansas hospital, there’s a good chance it isn’t in her home county.

Only 22 of Arkansas’ 75 counties now have hospitals that deliver babies, according to the Arkansas Center for Health Improvement (ACHI). Thirty hospitals overall still do, including counties with more than one. Ten hospitals have closed their obstetrics units since 2019. The latest is National Park Medical Center in Hot Springs following the unexpected death of its only obstetrician-gynecologist. Another local hospital, CHI St. Vincent Hot Springs, will continue delivering babies.

Five of the 10 closed their units because of staffing shortages, while five did so for financial reasons, ACHI says. Labor and delivery units are expensive to operate and must be open 24-7, even in rural areas with low patient volumes.

The closures are part of a nationwide trend. The Center for Healthcare Quality and Payment Reform recently reported that since the end of 2020, 146 rural hospitals have closed their units or announced plans to do so by the end of 2026. 

Fewer hospitals means longer drive time

Naturally, closing a labor and delivery unit increases a mother’s travel time. 

Using mothers’ zip codes and the addresses of delivery facilities, ACHI calculated that women traveled a median number of 16 minutes for care in 2024. 

Those numbers varied widely based on location – from two in El Dorado’s Union County to 84 in rural north-central Searcy County. Twenty-nine percent of mothers were traveling at least 30 minutes. In Phillips County, median travel time increased from six minutes in 2019 to 48 in 2024 after Helena-West Helena’s labor and delivery unit closed in 2020.

Meanwhile, Arkansas had one of the nation’s highest maternal mortality rates at 38.3 per 100,000 live births from 2018 to 2022, according to the Centers for Disease Control and Prevention. During that timespan, 69 women died while pregnant or within 42 days of the pregnancy’s end from pregnancy-related causes.

The national rate was 23.2 per 100,000 live births, although the CDC says some states’ numbers are too small to be statistically reliable. 

Arkansas also had the nation’s second highest infant mortality rate in 2024 at 8.28 per 1,000, behind only Mississippi with 9.65. The CDC defines infant mortality as deaths within a year of birth.

About half (47%) of births in Arkansas were funded by Medicaid in 2024, ACHI says. The government program that serves lower income people pays hospitals less than insurance does. 

Arkansas is the only state that hasn’t extended postpartum Medicaid coverage from 60 days to a year, which has been allowed under federal law since 2022. Rep. Aaron Pilkington, R-Clarksville, has tried to pass legislation extending coverage. It easily passed the House last year but stalled in the Senate. He told me he will try again and guessed his chances of passing it are 60-40.

Gov. Sarah Huckabee Sanders has opposed extending coverage. She has said the state should better help moms access the care options that already exist. Her Strategic Committee on Maternal Health’s recommendations were included in the Healthy Moms, Healthy Babies Act, which lawmakers passed last year. 

That law, of which Pilkington was the lead House sponsor, provides $45 million annually for maternal and infant care, offers up to 14 prenatal and postnatal care visits, and increased Medicaid reimbursements to providers for deliveries and caesarian sections by 70%. Spokesman Sam Dubke said Sanders “is actively seeking additional opportunities to help Arkansas moms and their kids.”

I asked Sanders’ election opponents how they would address maternal health issues.

Democratic Sen. Fred Love, D-Mabelvale, said driving long distances to the nearest hospital endangers the mother and baby. He said hospitals depend on Medicaid funding. He referenced the recent announcement that the Trump administration will not renew Arkansas’ ARHOME Medicaid expansion program waiver. The waiver’s denial affects health insurance coverage for more than 200,000 Arkansans. Sanders has requested an extension while policymakers consider an alternative. Love said elected officials must show they care by their actions.

Libertarian Party nominee Colt Shelby said Arkansas should expand Medicaid postpartum coverage to 12 months and should work to renew the ARHOME program. The insurance commissioner should try to make health coverage more accessible and affordable. He said resources from the $50 billion federal Rural Health Transformation Program should be provided to rural providers. 

Health care will take center stage during next year’s legislative session because of the ARHOME waiver denial. Maternal health will be part of that discussion. 

Meanwhile, hospital labor and delivery units will continue to face financial pressures and staffing shortages. 

Let’s hope no more maternity units close. Pregnancy and childbirth are no times for a long drive. 

© 2026 by Steve Brawner Communications, Inc.

Steve Brawner’s column is syndicated to 24 news outlets in Arkansas. Email him at brawnersteve@mac.com.