The Reference Committee recommends this be adopted as new ArMA Policy.

Does the resolution address a current need? Yes, maternal outcomes need improvement in Arizona.

Is it directly applicable to the healthcare community? Yes, it applies to peripartum care and expanding access to obstetric providers.

Does it reflect emerging healthcare trends? Yes, maternal health is an important focus in healthcare.

Is it within ArMA's or the AMA's scope to accomplish? Yes, ArMA can support policies that would improve maternal health.

Whereas, Arizona continues to experience significant disparities in maternal health outcomes, including higher rates of severe maternal morbidity, inadequate prenatal care, and adverse birth outcomes in rural and underserved populations compared with urban regions^1,2; and

Whereas, geographic inequities in obstetric access persist, with at least one Arizona county classified as a maternity care desert and multiple counties identified as having limited maternity care access, resulting in increased travel distances and delayed care for pregnant patients³; and

Whereas, physician-led interdisciplinary maternity care models, rural training tracks, and telehealth-supported obstetric consultation have been shown to improve the coordination of care in underserved areas^4,5; and

Whereas, expanded infrastructure allows appropriately trained family physicians to provide comprehensive obstetric care in under-resourced communities⁶ and the Society for Maternal Fetal Medicine supports expansion of the maternity care team to improve maternal health outcomes⁷; and

Whereas, a majority of high-risk pregnant rural patients deliver in facilities with inappropriately low-level care despite the fact that states with perinatal regionalization systems are better able to utilize limited maternal-fetal medicine resources and telehealth can facilitate appropriate transfers^8,9; and

Whereas, Arizona initiatives such as AHCCCS-funded maternity care supports and maternal mortality review efforts demonstrate progress but require broader implementation and sustained investment to meaningfully reduce preventable maternal morbidity and mortality¹; therefore, be it

Resolved, that ArMA advocates for expanded access to comprehensive prenatal, intrapartum, and postpartum care throughout Arizona, especially in rural areas, including the use of telehealth-supported consultations; and be it further

Resolved, that ArMA supports the evaluation and adoption of evidence-based programs that improve maternal health outcomes and reduce preventable maternal mortality; and be it further

Resolved, that ArMA supports the use of maternal mortality and morbidity review committees to facilitate ongoing data collection and reporting on maternal morbidity, mortality, and maternity care access disparities in Arizona to guide equitable policy interventions and resource allocation; and be it further

Resolved, that ArMA encourages the recruitment and retention of obstetric providers in rural and underserved areas through student and resident exposure to rural obstetric practice environments, loan repayment programs, enhanced Medicaid reimbursement for maternity services, medical liability support mechanisms, and rural practice incentives; and be it further

Resolved, that ArMA encourages expanded training programs in management of pregnant patients and availability of obstetric resources for family medicine and emergency medicine physicians working in rural areas; and be it further

Resolved, that ArMA supports the utilization of physician-led, integrated care models to enhance the delivery of obstetric services in maternity care deserts.

Reference:

1. Arizona Department of Health Services. Arizona Maternal Mortality Review Program Annual Report. Phoenix, AZ: ADHS; 2023.
2. Centers for Disease Control and Prevention. Pregnancy Mortality Surveillance System. Updated 2022.
3. March of Dimes. Nowhere to Go: Maternity Care Deserts Across the U.S. 2023 Report. Arlington, VA; 2023.
4. Centers for Medicare & Medicaid Services. Maternal Health Models and Medicaid Innovation Initiatives. 2023.
5. National Rural Health Association. Rural Maternal and Obstetric Care Toolkit. 2021.
6. Rodney WM, Rodney Arnold K, Rodney JRM, Behymer N, Fox C, Albitawi M. Sustainable Family Medicine Obstetrics as a Safety Net for Marginalized Low Resource Communities 2005-2022: The Impact of Expanded Training and Office Redesign. J Am Board Fam Med. 2025;38(2):199-208. Published 2025 Jun 27. doi:10.3122/jabfm.2024.240161R2
7. Society for Maternal-Fetal Medicine (SMFM), Gaur P, Goulding AN, Spong CY, Werner EF; SMFM Health Policy and Advocacy Committee. Society for Maternal-Fetal Special Statement: Transforming the maternity care team model. Pregnancy (Hoboken). 2025;1(3):e70018. doi:10.1002/pmf2.70018
8. Handley SC, Formanowski B, Passarella M, et al. Risk-Appropriate Childbirth Care Among Higher-Risk Pregnant Rural Residents. JAMA Health Forum. 2025;6(11):e254241. doi:10.1001/jamahealthforum.2025.4241
9. Miller HE, Yee LM, Heuser C, et al. SMFM Special Statement: Opportunities to improve access to maternal-fetal medicine care in rural and underserved communities. Pregnancy. 2026;2:e70211. doi:10.1002/pmf2.70211.