More than a year after its launch, The Maternal and Infant Health (MaIH) Center in Lexington, Missouri, continues to be a critical resource for expectant parents in Lafayette County and in urban areas in Missouri and Kansas. Established by Altruism, Inc., a 501 (c) (3) non-profit, to address maternal health disparities, the Center provides whole-person care—offering prenatal education, doula and midwifery support, postpartum services, and essential supplies such as diapers, car seats, and clothing.

Missouri has one of the highest maternal mortality rates in the U.S., and the crisis is especially severe in rural areas. According to the Missouri Department of Health and Senior Services, nine of the 10 Missouri counties with the highest infant mortality rates are rural, where the absence of adequate health care services puts expectant parents at greater risk. For many families in rural Lafayette County, the nearest OB-GYN is more than 45 minutes away, making consistent prenatal and postpartum care difficult to access.

The MaIH Project launched in 2022 as a pilot project in the Kansas City area. A year later, The MaIH Center, a pregnancy center, was established to provide relationship-based maternal care in Lafayette County. Now, more than a year later, staff members and partners reflect on its progress, ongoing challenges, and the work ahead.

Since opening in November 2023, The MaIH Center has delivered comprehensive prenatal and postpartum care to families who otherwise might not have access. The center provides:

  • Doula and midwifery services that support expectant parents through pregnancy, labor, and postpartum recovery, with a primary focus on rural families in Lafayette County and surrounding areas. To date, nearly 140 expectant parents have received doula support, and whole-person maternal care – reinforcing the Center’s role as a trusted resource in the community.
  • Educational programming to help families understand their birth options, create birth plans, and navigate pregnancy-related health concerns.
  • Essential baby supplies, including diapers, clothing, and car seats, through partnerships such as Happy Bottoms. The Center has distributed more than 5,100 diapers to families in need.
  • More recently, The MaIH Center has partnered with a rural-based mental health care provider that offers counseling services on site for birthing people during prenatal and postpartum stages.

Altruism, Inc., the parent organization of The MaIH Center, has also expanded its commitment to addressing food insecurity by partnering with University Health’s FoodFARMacy initiative. Through this collaboration, Altruism helps distribute fresh produce bags twice monthly to families, supporting overall health and nutrition in the community. Families receiving services at The MaIH Center benefit from these efforts, ensuring that expectant and postpartum parents have access to nutritious foods.

“Even before grocery prices skyrocketed, food insecurity was an issue here,” said Chelsea Huffman, a community health worker at Altruism, Inc. “We have food pantries open every Friday, commodities that come in once a month, and Harvesters rolling through, and I still hear about people who can’t feed their families. That’s why I love that we’re helping people with quality food, no matter their ability to pay.”

Challenges in Serving Rural Communities

Despite its success, significant barriers remain for rural maternal health care. Funding continues to be a primary challenge, as The MaIH Center operates on grants and community support to sustain its free services.

“I am a lifelong Lexington resident,” Huffman said. “My husband and I grew up here, and we don’t plan on going anywhere else. When you live in a rural town, your community becomes an extension of your family. That’s why I love the work we do at The MaIH Center—it’s not just about services, it’s about relationships.”

Beyond financial sustainability, geographic and infrastructure barriers continue to affect maternal health outcomes. With limited public transportation and long travel distances, many rural mothers struggle to attend medical appointments consistently. In some cases, families lack reliable childcare, making it even more difficult for pregnant women to prioritize their health.

“People in rural communities are used to making things work with what we have,” Huffman added. “But when it comes to maternal care, we can’t just ‘make do’—moms and babies need real access to services. That’s why The MaIH Center is so important. It fills a gap that shouldn’t exist in the first place.”

Language barriers also exist within populations in Missouri and Kansas. In response, The MaIH Center provides Spanish-speaking doulas, helping to bridge cultural and linguistic gaps that often prevent patients from seeking care. While the Center focuses on rural families, Altruism’s reach includes Jackson and Wyandotte Counties, reinforcing the organization’s commitment to maternal health access across urban and rural communities alike.

“When you’re in a rural community and your resources are limited, you really rely on one another,” Huffman said. “That’s given me that servant heart—helping others however we can, whether it’s sharing extra eggs from our chickens or connecting families with the resources they need.”

Staff and partners agree that more investment is needed in rural health care infrastructure, including better access to transportation and funding for maternity care centers in underserved areas. Without these systemic changes, organizations like The MaIH Center must work even harder to fill the gaps left by traditional health care systems.

“We have such a dedicated team,” said Tonia Wright, Altruism’s CEO. “Our doula, midwifery, community health workers, and support staff put their hearts and souls into this work. Everyday, I see the work ethic and commitment they expend to serve the greater good.”

Growing Policy Threats Put Maternal Health in Jeopardy

Like many other community-based organizations, The MaIH Center operates in a rapidly changing policy environment, where state and federal decisions directly impact maternal health services. These decisions have never been more consequential. 

At the federal level, the Trump administration has proposed slashing $880 billion from Medicaid over the next decade, aligning with a House Republican budget plan that would gut health care funding for millions of low-income Americans, including expectant mothers who rely on Medicaid for prenatal and postpartum care. The proposed cuts would also impact the Children’s Health Insurance Program (CHIP), which provides health coverage for nearly 40% of children in the U.S. and helps pay for half of all births nationwide. If CHIP funding is reduced, millions of newborns and their mothers could lose access to essential postnatal care, increasing the risk of preventable complications. If enacted, these cuts will push rural hospitals closer to closure, strip critical maternal health services, and force thousands of mothers to give birth without proper medical oversight. 

Beyond direct funding cuts, House Republicans are also considering Medicaid work requirements, a policy that has already resulted in thousands of eligible individuals losing coverage in states where it has been implemented. In 2018, Arkansas became the first state to enforce Medicaid work requirements, causing over 18,000 people to lose coverage within the first year—many due to administrative hurdles rather than actual employment status.  

Most Medicaid recipients are already working or qualify for exemptions, such as being caregivers, students, or individuals with disabilities. However, as seen in Arkansas, the administrative burden of work requirements often leads to eligible individuals losing coverage, not an increase in employment. These policies disproportionately harm low-income parents, including expectant mothers who rely on Medicaid for prenatal care.

While there is no direct data linking this policy to worsening maternal and infant mortality rates, Arkansas continues to rank among the worst states for maternal and infant health. According to the March of Dimes, Arkansas received an ‘F’ grade for preterm births in both 2017 and 2024, with its preterm birth rate increasing from 11.6% to 12.1% over that period. The state also has an infant mortality rate of 7.7 per 1,000 live births, well above the national average. These persistent challenges highlight why stable and uninterrupted healthcare coverage is critical for expectant mothers. 

Missouri faces similar risks. If Medicaid work requirements or other restrictive policies are enacted at the federal level, expectant parents in Missouri could experience the same disruptions seen in Arkansas—losing coverage at a time when maternal healthcare access is already in crisis.

The state is already struggling with maternal health access and will be one of the hardest-hit states. More than 51.6% of Missouri’s counties are classified as maternity care deserts, meaning there are no hospitals or birth centers providing obstetrics care. Recent hospital closures have made access even more precarious, forcing expectant parents to travel more than an hour for care. These challenges disproportionately impact Black and Indigenous mothers, who already experience the highest maternal mortality rates in the U.S. 

Meanwhile, state-level actions are compounding the crisis. Despite voter approval of Medicaid expansion in 2020, Missouri lawmakers continue to introduce measures that restrict eligibility, limiting access for low-income individuals. Additionally, House Bill 807, known as the “Save MO Babies Act,” proposes tracking pregnant individuals who may seek abortion services—a measure that raises serious privacy concerns and could deter women from seeking essential prenatal care. 

Missouri is not alone in advancing legislation that expands government oversight into pregnancy-related health care decisions. In Montana, House Bill 609, known as the “Infant Safety and Care Act,” proposes criminal penalties for what it calls “fetus trafficking,” raising alarm among legal experts and health care providers over the potential targeting of pregnant individuals and those assisting them. These legislative efforts, though framed as protecting unborn life, risk creating a climate of fear that discourages individuals from accessing necessary medical care, including prenatal and postpartum services. 

As policymakers debate funding priorities, organizations like The MaIH Center must continue to advocate for solutions that expand access to high-quality, localized maternal care. The Center is actively seeking new funding streams and legislative support to ensure that birthing people residing in rural and urban communities access the care they deserve.

“With limited funding opportunities, we are finding workarounds to continue to not only deliver these services, but scale in a meaningful way that offers the most impact,” Wright said. “In this current climate, organizations will need to come together more than even to leverage each other’s strengths to maximize collective impact. As we reflect on potential cuts to Medicaid and other safety net programs, we are looking at ways to ensure our business model remains responsive to these changes and their potential for profound effects. We ask that you contact your state representative and congressperson. Let them know how these changes will affect families and many hard-working, employed individuals. Cuts to Medicaid, in particular, will level a horrific blow to health care access, increase medical costs, health inequities, hospital closures, and threaten the solvency of community health centers, among so many other domino effects.”

What’s Next for The MaIH Center?

As demand grows, The MaIH Center is working to expand its programs and partnerships to meet community needs. While policy changes and funding challenges threaten maternal health services nationwide, the Center is actively developing solutions to close gaps in care. 

“We have no choice but to track what’s happening at the federal and state levels,” Wright said. “But even with that, we remain inspired to do this important work, optimistic that we’ll round this corner unscathed, and activated to advocate alongside like-minded friends, colleagues, and partners on behalf of the communities we serve. Our goal is steady and true: to help move Missouri from the bottom, 44th in the nation, when it comes to maternal and infant health, up to the top. And that will take ongoing commitment, resilience, community support, and a strong network of partners.” 

The urgency is real. Proposed Medicaid cuts and state policies like House Bill 807 will deepen the maternal health crisis, forcing more rural hospitals to close and cutting off critical services for expectant parents. Altruism, Inc. and the MaIH Center are working every day to fill these gaps, but without action, the demand will far exceed available resources.

If Medicaid and CHIP funding are slashed, where will these families go? With hospitals already closing and community health centers stretched thin, the options are disappearing. Private insurance remains out of reach for many low-income families, leaving expectant parents with nowhere to turn. Without a safety net, maternal and infant mortality will rise—disproportionately affecting rural, low-income, and communities of color.

The Urgency to Act: Protecting Maternal Care Before It’s Too Late

Lawmakers must act now to protect Medicaid and invest in maternal health. The MaIH Center and its partners will continue advocating, but systemic change is needed. Contact your representatives today and make your voice heard before it’s too late

For more information about The MaIH Center, or how to support its mission, visit Altruism, Inc.