Across continents, the fight to secure affordable, accessible, and safe maternal health care is taking center stage, with Arkansas in the United States and Ogun State in Nigeria facing parallel challenges—albeit shaped by different laws, cultures, and resources. Both regions are grappling with high maternal mortality rates, persistent gaps in reproductive health services, and the consequences of policies that restrict access to trusted providers.
In Arkansas, the story begins with a significant shift that occurred seven years ago. The state’s Medicaid program—vital for low-income residents—cut off funding to Planned Parenthood, a move that reverberated throughout the Natural State’s health care landscape. According to the Arkansas Advocate, this policy change meant that Medicaid patients could no longer rely on Planned Parenthood’s clinics in Little Rock and Rogers for annual physicals, cancer screenings, or testing for sexually transmitted diseases. While abortion remains a lightning rod in public debate, the bulk of services affected were basic, preventive care.
“We want every person, whatever their income status, to know that they can get the same high quality services, but because of politics, now those patients are having to find new providers if they can, and many times [they] are facing delays on their care because they can’t find another provider that they can’t get into very quickly,” said Emily Wales, CEO of Planned Parenthood Great Plains, in an interview with the Arkansas Advocate.
The situation worsened in 2022, when Arkansas enacted a near-total abortion ban. Yet, even before that, federal law had already prohibited Medicaid from funding most abortions. The combined effect? Many low-income Arkansans, particularly women, have found themselves scrambling to locate new, often unfamiliar providers—if they can find one at all. Medicaid reimbursements in Arkansas are notoriously low, discouraging many doctors from accepting such patients. For those who can’t easily travel, crossing state lines for care is a nonstarter, since Medicaid coverage doesn’t extend out of state. As Wales points out, “That problem will only be exacerbated if Medicaid patients can’t get care at Planned Parenthood anywhere.”
The threat is not just local. Nationally, Planned Parenthood has warned that at least 200 of its roughly 600 clinics could shutter if Medicaid funding restrictions continue. As of October 2025, none of the Great Plains clinics, including those in Arkansas, are slated for closure. However, the legal and financial battles rage on. In July 2025, Planned Parenthood filed a federal lawsuit to block a budget provision targeting its Medicaid funding. While a district court initially issued a preliminary injunction, an appeals court overturned that ruling in September, leaving the future uncertain.
What does this mean for patients? In Arkansas, the Department of Health operates local health units in all 75 counties, offering low- or no-cost reproductive health services. Federally qualified health centers—more than 200 of them—also provide care regardless of a patient’s ability to pay. But there’s a catch: these centers haven’t traditionally specialized in women’s health, though that’s beginning to change. The Arkansas Center for Women and Infants’ Health is collaborating with providers to expand access for pregnant and postpartum patients, and is developing a perinatal care curriculum for community health workers, expected by spring 2026.
Despite these efforts, Arkansas faces grim statistics. The state has one of the nation’s highest maternal mortality rates and the third-highest infant mortality rate, according to the Arkansas Center for Health Improvement. Recruiting and retaining OB-GYNs is a persistent struggle, and as of 2022, there were only 9.2 primary care physicians per 10,000 residents. “A lot of the FQHCs have decided that they’re going to take on prenatal care because they see that need in their community of being able to enhance access,” said Krista Langston, CEO of the Arkansas Center for Women and Infants’ Health.
Efforts to bridge the gap include the Healthy Moms, Healthy Babies Act of 2025, which allows Medicaid reimbursements for community health workers providing pregnancy-related services. Community health centers often partner with hospitals, referring pregnant patients for delivery after 32 weeks’ gestation. Still, as Laura Little, nursing director at River Valley Primary Care Services, noted, “We are seeing that there is a longer wait time just for those routine visits, [but] if you’re pregnant, you can get right in with specialty gynecologists.”
Meanwhile, the ongoing federal government shutdown in 2025 has created significant financial challenges for these community health centers, threatening to stretch resources even thinner.
Thousands of miles away in Ogun State, Nigeria, the battle for safe maternal care takes on a different but equally urgent character. On October 10, 2025, Dr. Elijah Ogunsola, Executive Secretary of the Ogun State Primary Healthcare Board, reaffirmed the state’s commitment to implementing Safe Termination of Pregnancy (SToP) guidelines. As reported by Punch, this initiative aims to enhance safe and legal abortion services within the boundaries of Nigerian law—a critical step in a country where unsafe abortion is a leading cause of maternal mortality.
At a seminar themed “Breaking Barriers to Safe Termination of Pregnancy to Save Lives,” Ogunsola didn’t mince words: “There is an urgent need to address unsafe abortion as a public health crisis. Unsafe abortion remains one of the top five direct causes of maternal mortality in Nigeria, with an alarming 97 percent of such cases occurring among women from low- and middle-income backgrounds.” He highlighted the deadly combination of limited access to accurate information, safe services, and the persistent stigma surrounding reproductive health.
The Nigerian constitution supports the right to access safe abortion care within legal boundaries, reinforcing the state’s responsibility to protect women’s health and rights. However, abortion in Nigeria is only legal when necessary to save a woman’s life, or in cases such as rape, cancer, or incest. Even then, procedures must be performed by qualified health professionals in hygienic environments. Unfortunately, most abortions in Nigeria are clandestine and performed by unskilled providers, resulting in high rates of maternal death, illness, and disability. Nigeria’s maternal mortality ratio remains among the world’s highest, with little improvement in recent years.
Dr. Moriam Jagun, Executive Director of the Centre for Bridging Health Gaps, called unsafe abortion “one of the most preventable causes of death, yet one that continues to endanger the lives and futures of vulnerable women and girls.” She urged governments, policymakers, healthcare professionals, legal experts, faith leaders, and civil society to work together to improve access to evidence-based, life-saving care. “There are various existing opportunities for women to make choices that are rights-based and within the legal framework,” she noted.
During a panel session, Mrs. Oluwakemi Lawal, Director of the Citizens’ Rights Department, clarified that abortions can be legally performed in Nigeria when a pregnancy endangers the mother’s life or physical health, and only by qualified professionals. Dr. Olusoji Jagun, representing the Society of Gynaecologists and Obstetricians of Nigeria, emphasized that safe abortion upholds women’s rights to make informed decisions about their reproductive health without fear of legal repercussions or social stigma. He called for increased public awareness of the SToP guidelines and the importance of safe abortion services.
What unites Arkansas and Ogun State is a shared recognition: maternal health care cannot be improved without confronting the barriers—political, legal, financial, and cultural—that keep women from safe, affordable, and trusted care. The stakes are high, and the solutions, while complex, are urgently needed. As both regions press forward, the hope is that collaborative, rights-based approaches will finally begin to close the deadly gaps.
