Gov. Sarah Huckabee Sanders appointed Manning as an inaugural member of the Arkansas Maternal Mortality Review Committee. (Provided)
In 2020, Dr. Nirvana Manning was named chair of the Department of Obstetrics & Gynecology at UAMS in Little Rock, where she had served as director and medical director of women’s health services. She is an elected member of the Arkansas Medical Society’s board of trustees. She has been active in education regarding access to contraception for all women in Arkansas. She also works on several projects and grants to reduce maternal morbidity and mortality in Arkansas. n and improve the care of women in the postpartum period.
She earned her undergraduate degree in economics and biology, graduating cum laude, from Vanderbilt University. She graduated from UAMS’ medical school in 2003 and remained at UAMS for her residency in obstetrics and gynecology.
What public policy change would have the greatest impact on maternal health in Arkansas?
Extending postpartum Medicaid coverage to 12 months with automatic continuous enrollment would have the greatest impact. Arkansas is currently the only state that has not adopted the federal option to extend postpartum Medicaid from 60 days to 12 months. Alarmingly, one-third of pregnancy-related deaths in Arkansas occur between 43 and 365 days postpartum. This single policy change could target the most vulnerable period for postpartum women and significantly reduce maternal mortality.
What factors led to Arkansas becoming one of the worst states in the U.S. to be a pregnant or postpartum woman?
► Rural health deserts. Half of Arkansas counties have no obstetrical care, creating vast gaps in access.
► Workforce shortages. Arkansas ranks near the bottom nationally in provider-to-patient ratios for women of childbearing age and has one of the lowest numbers of certified nurse-midwives attending births.
► Low postpartum visit rates. More than 50% of women do not attend a postpartum visit, missing crucial opportunities to address contraception, mental health and other health concerns.
► Racial disparities. Black women in Arkansas face a three to four times higher risk of pregnancy complications, including preterm labor and delivery.
What can be done to address the limited health care access in rural areas for expectant mothers?
► Telehealth and remote monitoring. Leveraging technology with remote care models/telehealth with advances in medicine in the way of remote patient monitoring of blood pressures, blood sugars, fetal assessments and weight management. This is expanding statewide.
► Mobile units. Taking prenatal and postpartum care directly to underserved communities via mobile clinics helps bring care to where patients are.
► Standardized education. Ensuring consistent prenatal and newborn care education across hospitals through initiatives like those led by the Arkansas Center for Women & Infants’ Health.
► Postpartum identification. Employing programs like the I Gave Birth bracelet that alert health care providers a woman is in the postpartum period, which comes with unique medical risks and needs. n
How do you expect Medicaid cuts will impact health care for women and infants?
► Loss of coverage. Fewer women will have access to preventive care before pregnancy, leading to higher risks and worse outcomes during pregnancy.
► Maternity unit closures. Cuts could accelerate rural hospital closures. However, recent legislation like Gov. Sarah Sanders’ Healthy Moms, Healthy Babies initiative, which increases reimbursement for deliveries and adds presumptive eligibility and doula reimbursement, may help offset this.
► Infant care gaps. When mothers lose Medicaid, infants often miss essential well-baby visits, vaccinations and lactation support.
What are the most important things Arkansas can do to improve health care for pregnant women and new mothers?
► Advocate for women’s health and maternal equity.
► Support legislation expanding telehealth, mobile prenatal care and 12-month postpartum Medicaid coverage.
► Invest in community health workers, doulas and home-visiting programs to support at-risk families.
► Champion agencies like the Arkansas Center for Women & Infants Health and the Arkansas Perinatal Quality Collaborative, which are working to expand access, standardize care, and bring vital services to women across all regions of the state.
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