Birth doulas across Arkansas have formed a new organization to improve maternal health care across the state and help pass legislation they hope will make doula services accessible to more families.

Doulas are members of a birthing team providing emotional, physical and educational support to expectant mothers.

Cora Crain, cofounder and board vice president of the Doula Alliance of Arkansas, said research shows doula services can reduce cesarean sections, premature deliveries and length of labor.

"We have people reaching out to us. This is their first time they don't know what they don't know," Crain explained. "It's all very overwhelming. There's definitely a certain amount of fear that a lot of people are bringing to the birth experience and then of course if you had a doula in your previous birth then you usually continue."

Doulas provide services during pregnancy, childbirth and postpartum.

Members of the alliance are supporting a bill before state legislators next year mandating insurance companies and Medicaid to cover doula costs. Crain noted if passed, the legislation will make services available to more expectant mothers.

"Doula services can be so important in getting healthier outcomes and also just more positive experiences that lead to more positive postpartum times," Crain emphasized. "But it's just not as accessible to so many women that can't afford that out-of-pocket expense. "

Arkansas has one of the highest maternal mortality rates in the nation.


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Next week, Kentucky lawmakers are expected to consider a bill that would lift legal red tape that backers say makes it difficult to open up freestanding birth centers.

The Commonwealth is among 10 states with no independent nurse midwife-run facilities that provide prenatal and birth services and postpartum care. So, many people travel to Indiana or Tennessee to give birth, said Trimble County resident Paige Thompson, who went out of state to give birth in 2021. She said her friends have made similar trips, but she worries about those in other rural counties who have no options for a natural birth in a home-like environment.

"They offer the freedom to move around during labor," she said. "They offer the option to eat and drink whenever you're hungry or thirsty. And there's also the option to birth in the water."

Senate Bill 17 would exempt freestanding birth centers from the state's certificate-of-need requirements, rules that regulate health-care facilities. The Kentucky Hospital Association opposes freestanding birth centers, arguing that hospitals are better equipped to handle unpredictable medical complications.

The bill's sponsor, state Sen. Shelley Funke Frommeyer, R-Alexandria, said people should have access to the prenatal and delivery care they feel is best for them, noting there are around 800 home births in Kentucky each year.

"I want to recognize that we are not trying to do anything so complicated, other than remove barriers to wellness," she said, "and we believe that this is a very important barrier to remove."

Thompson said more than one in three Kentuckians give birth by cesarean-section, a rate among the highest in the nation.

"I think that people are waking up to the truth that midwives and midwifery care are safer, and produce better outcomes for low-risk pregnancy, in women who want a natural vaginal delivery," she said.

Data show access to birth centers is linked to fewer medical interventions and lower cesarean rates than in hospitals, and can reduce racial disparities, including fewer low birthweight babies for Black women.

Gov. Gretchen Whitmer recently signed landmark legislation to expand access to essential OB/GYN services across Michigan.

Between 2018 and 2022, about 19 mothers per 100,000 live births in Michigan died from pregnancy-related issues, mostly in marginalized communities. The new legislation aims to expand maternal and prenatal care.

Rep. Julie Rogers, D-Kalamazoo, a former health policy chair, sponsored several bills in the package, including one to reduce government red tape for breast milk donors.

"That required HIV testing for breast milk donors every 90 days, and to contrast that with the rest of the United States, we're the only state that requires that," Rogers pointed out. "Forty-nine other states do a one-and-done test at the onset of donations."

Data from 2022 showed white mothers having the highest number of maternal transfusions, followed by Black mothers.

A new report from the American College of Obstetricians and Gynecologists revealed a startling statistic: More than 60% of pregnancy-related deaths could have been prevented with improved quality and safety in the maternal care system.

Rogers noted the new law mandates insurance companies to provide support for people without health coverage or access to care.

"Often times people that are not able to access primary care or obstetrics care," Rogers observed. "This would require insurance coverage for blood pressure monitors, so mothers can check their blood pressure at home."

Rogers stressed the legislation expands access to postpartum mental health screenings. She added most bills in the package received strong bipartisan support in the Legislature.


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There are growing concerns about the prevalence of Christian Nationalism, an ideology that seeks to establish a theocracy rooted in Christian principles. Research indicates that about one-in-three Pennsylvanians support Christian Nationalist views, which opponents argue challenge the American ideal of separation of church and state.

Rachel Tabachnick, an independent researcher and former political research associate fellow, said the rise of Christian Nationalism, seen during the 2024 elections, threatens reproductive healthcare access.

"This is supposed to be a bottom-up theocracy based on biblical law being enforced at the family,
church and local civil government level. So, in order for this to work, women must stay in their God given roles, which is to have children and raise her family," she said.

On a recent episode of the "(In)Accessible" podcast, Tabachnick spoke about the history of Christian Nationalism, and how Theocratic Libertarianism advocates for laws based on biblical principles.

Tabachnick said that movement seeks minimal federal government and governance based on biblical law, aiming to dismantle institutions like the IRS and Department of Education.

Rebecca Susman, communications and development director with Keystone Progress, added that Project 2025, a 900-page guide by the Heritage Foundation, is intended as a blueprint for another Trump administration. The guide covers numerous issues, which Susman argues pose threats to basic rights and freedoms, particularly reproductive rights. She added that aspects of the plan were proposed last year.

"Conservatives have already begun implementing it, with one example being the addition of an anti-trans health care rider in a military spending act that was right out of the Project 2025 playbook, and it passed out of committee," Susman explained.

Tabachnick pointed out that in the 1970s and 1980s, the founders of Christian Reconstructionism wrote thousands of pages detailing how to reshape society and government under Old Testament law. Decades later, these blueprints remain relevant, as they were designed for a long-term transformation. Like Project 2025, most Americans reject these ideas, but they still need greater exposure and scrutiny.