In Mississippi’s Maternal Health Crisis, Pharmacies Become Lifelines

Sarah, aged 24 years and 15 weeks pregnant, was referred to the local pharmacy from a women’s resource center. She was new to the health care system and had no insurance, no primary care provider, no prenatal care, no money, and no hope. Sarah was worried about her baby’s health and her own. Luckily for her, Love’s Pharmacy offers more than just dispensing of medications. Love’s Pharmacy, a part of the Community Pharmacy Enhanced Services Network Mississippi (CPESN MS) and CPESN Community Health (CPESN CH), partnered with the Community Pharmacy Foundation (CPF) to launch Medications Optimizing Maternal Safety (MOMS).

MOMS is a clinical service to support expectant mothers. Once enrolled, Sarah received monthly prenatal vitamins and iron, as well as routine screenings and resolution of health-related social needs. She was screened for and administered immunizations and assessed for preeclampsia risk, depression, and hypertension. The pharmacy staff coordinated with the women’s resource center to help Sarah enroll in Mississippi’s Medicaid program. The pharmacy coordinated and scheduled an initial appointment with the local obstetrician-gynecologist (ob-gyn), which was done within the first week of visiting the pharmacy. The change in Sarah was evident. She was joyful, excited, and thankful for Love’s Pharmacy as she began her new journey into motherhood.

Sarah’s story is not unique in Mississippi. The newest epidemic in Mississippi isn’t opioid overdose, cardiovascular disease, or even emergent respiratory illnesses. It’s maternal health outcomes.

Understanding The Magnolia State’s Health Disparities

Mississippi remains one of the lowest-ranking states in major chronic diseases and health indicators. In 2024, Mississippi ranked last in the US overall for infant mortality and 45th for maternal mortality. Furthermore, Mississippi ranked 48th for diabetes and obesity and 49th for hypertension.¹

In Mississippi, 51.2% of counties are defined as maternity care deserts compared with 32.6% of counties in the US. As a result, Mississippi also has the country’s highest infant mortality rate at 9.7 deaths per 1000 live births. Nearly 10 in 1000 babies born to Mississippi mothers die before they are 1 year old. Nationally, 5.6 babies die per 1000 born.^2,3 The Mississippi State Department of Health declared infant mortality a public health emergency in August 2025. In direct response to this emergency, the state developed a multipronged strategy that specifically includes expanding community health worker (CHW) programs to connect mothers and babies with care and resources where they live.² The enhanced workforce of CHWs will help prevent many of the major causes of illness and death currently holding Mississippi back.

Take Silvia, another patient in MOMS. She speaks only Spanish and requires a translator to navigate the health care system. The pharmacy helped schedule and coordinate an ob-gyn visit during a MOMS encounter, including setting up routine use of a translator associated with the health system for future visits.

MOMS: Medications Optimizing Maternal Safety

CPESN MS has been working with public health stakeholders across the state to address these significant health disparities. Initially, CPESN MS focused on workforce development by cross-training pharmacy technicians as CHWs with the goal of using this workforce to implement a variety of programs, from diabetes optimization to chronic obstructive pulmonary disease. The maternal health care crisis kindled something new.

MOMS is a partnership between CPESN MS, CPESN CH, and CPF. The objective of the program is to use local community pharmacies staffed with clinical pharmacists and CHWs as providers of maternal care and care coordinators. The community pharmacies are located in maternal care deserts, equipped with the right workforce to optimize care, and are readily accessible to members of local communities.

The program provides monthly MOMS medications, which include OTC prenatal vitamins, iron supplements, and low-dose aspirin when clinically appropriate. Aspirin is prioritized because it is a level 1A recommendation from the American College of Obstetrics and Gynecology for reducing the risk of preeclampsia. Additionally, CPESN MS and CPESN CH coordinated with stakeholders from Mississippi Medicaid in the development of MOMS, and the state requested support in improving this metric. Fortunately for Kristy, another patient in MOMS, pharmacies in CPESN MS have the opportunity to provide patient-centric support for patients with high-risk pregnancies. Kristy is pregnant for the fourth time. Her first pregnancy ended with stillborn twins, her second ended in miscarriage, and her third resulted in a healthy baby boy. Kristy is at high risk for preeclampsia and is indicated for aspirin. The pharmacist initiated low-dose aspirin for Kristy during a MOMS visit and coordinated follow-up care with a new ob-gyn.

Participants can also choose adherence packaging and home delivery to make access easier and more consistent. Each month, participants have check-ins with the pharmacy team. These check-ins include screenings for nonmedical drivers of health and trimester-specific assessments covering vaccines, mental health, and blood pressure. When vaccine gaps are identified, the team can help schedule and administer vaccines for both the mother and household members. Mental health is supported through depression screening using the PHQ-9 tool, and blood pressure is monitored regularly to ensure safety. All encounters and interventions are documented by the pharmacist. The data, using the pharmacist e-care plan data standard, is shared with CPESN MS and CPESN CH leadership for analysis and quality improvement.

Patient enrollment in the program can be initiated by pharmacy staff; however, most referrals have come from other community partners, such as local women’s resource centers. In addition, pharmacist-led in-service sessions are provided to local providers, and a pharmacy-based CHW conducts targeted outreach to local high schools, health departments, women’s centers, and family health centers to promote program awareness and facilitate referrals.

Outcomes From MOMS

MOMS started in August 2025. The pilot included 3 pharmacies in the Mississippi Gulf Coast. All pharmacies were required to be active members of CPESN MS, CPESN CH, and have a community health worker on staff. By the end of 2025, 43 unique patients received over 99 encounters with pharmacy staff. The average patient age was 26 years, ranging from 18 to 40 years.

The Figure shows the frequency of visits based on pregnancy week for each pharmacy-patient encounter. The majority (84%) of encounters occurred within the first 16 weeks of pregnancy, indicating that pharmacy providers were available to help patients early in the pregnancy journey. MOMS was provided as an in-person service within the pharmacy (41%), in person at the patient’s home (24%), or via telehealth (35%). Only 23% of patients had commercial insurance. Forty-three percent had Medicaid, and 23% were uninsured.

The clinical impacts are also significant. Seventeen percent of patients were started on aspirin by the pharmacy team. Patients were screened and referred for depression (7%) and hypertension (20%). However, the most impact was from the health-related social need (HRSN) screening and referral. Over 65% of patients had some type of HRSN identified. Often, these were transportation challenges, access to care, or inadequate housing.

Take Ashley, for example. She had no transportation, a distrust of vaccines, and was awaiting eviction. The pharmacy was able to establish delivery services for MOMS vitamins and iron, coordinate food and housing with a local county resource center, help obtain a breast pump, car seat, and a pack-and-play from a local hospital, and schedule vaccines with a new ob-gyn, all in one encounter.

Where We Are Now

CPF supported MOMS from the beginning. In 2026, CPF is helping expand MOMS to more pharmacies in Mississippi. The CPESN MS team is using this program to showcase the impact of community pharmacies on local lives. A business case is being made to sustain these services in community pharmacies with both national payors and state leaders.

But the most important aspect of MOMS is the patient care. Sarah came into the pharmacy last week. She wanted to introduce her healthy baby girl, Amy, to the pharmacy staff.

REFERENCES

1. Mississippi 2025 Public Health Report Card. Mississippi State Department of Health. Accessed February 11, 2026. https://msdh.ms.gov/page/resources/21518.pdf

2. MSDH unveils 2025 public health report card. News release. Mississippi State Department of Health. January 21, 2026. Accessed February 10, 2026. https://msdh.ms.gov/msdhsite/_static/23%2C30667%2C341.html?utm_source=chatgpt.com

3. Where you live matters: maternity care in Mississippi. March of Dimes. 2023. Accessed February 10, 2026. https://www.marchofdimes.org/peristats/assets/s3/reports/mcd/Maternity-Care-Report-Mississippi.pdf?utm_source=chatgpt.com