MOST POSTPARTUM MOMS IN ARKANSAS HAVE NO FOLLOW-UP VISIT AFTER AN ACUTE BEHAVIORAL HEALTH EVENT, ACHI ANALYSIS FINDS

LITTLE ROCK ― More than half of postpartum mothers in Arkansas who experience an acute mental health or other behavioral health event requiring an emergency room visit or inpatient stay do not have a follow-up outpatient visit, a new analysis by the Arkansas Center for Health Improvement finds.

As part of continuing analyses of the factors contributing to Arkansas’ maternal health crisis, ACHI examined outpatient, emergency room, and inpatient behavioral health events among 80,704 mothers who gave birth between Jan. 1, 2019, and June 30, 2022. ACHI also reviewed the timing of follow-up visits among postpartum Arkansas mothers following a behavioral health event requiring an emergency room visit or inpatient stay. The analysis found that 59% of postpartum mothers had no follow-up behavioral health visit within 120 days of an emergency room visit, and 56% had no follow-up behavioral health visit within 120 days of an inpatient stay.

ACHI also found that 29% of the postpartum mothers, or more than 23,000, had an outpatient visit related to a mental health diagnosis during the 12 months following a birth, compared with 17% during the nine months before a birth. Two percent of mothers, more than 1,600, had an emergency room visit for a mental health diagnosis during the postpartum period, and 2% required an inpatient stay.

“Arkansas has one of the highest maternal mortality rates in the nation, but maternal deaths are not the whole story,” said ACHI President and CEO Dr. Joe Thompson. “Behavioral health conditions are one of the most common complications of pregnancy and childbirth. Fortunately, there is hospital access to stabilize pregnant women or new mothers during an acute event, but we must also work to ensure they receive the follow-up care necessary to help them continue to heal.”

Additional ACHI findings include:

• Behavioral health events were more likely to occur in the postpartum period compared with the prenatal period.
• 455 mothers included in the analysis were seen in the emergency room for a substance use disorder during the postpartum period, and 500 required an inpatient stay for a substance use disorder.
• Postpartum mothers consistently had lower rates of follow-up visits after an emergency room visit or an inpatient stay compared with all women ages 18-44 in Arkansas.

A previous ACHI analysis of severe maternal morbidity, defined by the Centers for Disease Control and Prevention as “unexpected outcomes of labor and delivery that result in significant short- or long-term health consequences,” found that more than one-third of severe maternal morbidity events occurred between six weeks and one year after a birth. The severe maternal morbidity definition did not include behavioral health conditions.

ACHI also noted in a previous infographic that 19.7% of new Arkansas mothers reported experiencing postpartum depression in 2021. In the best-performing state, Vermont, just 8.7% of new mothers reported experiencing postpartum depression in 2021.

“We assume that when the mother goes home from the hospital, all is well with her and her baby, but frequently that is not the case,” said Thompson. “This should be a wake-up call to all of us that we need to continue to support our mothers throughout their birthing journeys. That includes learning to recognize signs of depression and other mental health challenges our mothers may be experiencing and reaching out to help. Families, neighbors and faith-based communities can all play a part.”

An infographic containing findings from the maternal behavioral health analysis is available on ACHI’s website at achi.net. The data source for the analysis is the Arkansas Healthcare Transparency Initiative’s All-Payer Claims Database.

More of ACHI’s findings on maternal and infant health in Arkansas are available at achi.net/maternal-infant-health.

ACHI is a nonpartisan, independent health policy center that serves as a catalyst for improving the health of all Arkansans through evidence-based research, public issue advocacy, and collaborative program development.