In Mississippi’s Maternal Health Crisis, Pharmacies Become Lifelines

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

MOMS is a clinical service to support expecting mothers. Once enrolled, Sarah received monthly prenatal vitamins and iron, routine screenings and resolution for health-related social needs, 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 Medicaid. The pharmacy coordinated and scheduled an initial appointment with the local obstetrician-gynecologist (OBGYN), which was established within the first week of visiting the pharmacy. The change in Sarah was evident. She was joyful, excited, and thankful for Love’s Pharmacy on 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.

Mississippi: The Magnolia State

Mississippi remains one of the lowest-ranking states in major chronic diseases and health indicators. In 2024, Mississippi ranked 50th 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 to 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 health care. The pharmacy helped schedule and coordinate an OBGYN 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 Mississippi has been working with public health stakeholders across the state to address these significant health disparities. Initially, CPESN Mississippi focused on workforce development through cross-training pharmacy technicians as CHWs with the goal of using this workforce to implement a variety of programs, from diabetes optimization care to chronic obstructive pulmonary disease programs. The maternal health care crisis kindled something new.

MOMS is a partnership between CPESN MS, CPESN Community Health (CH), and CPF. The objective of the program is to use local community pharmacies staffed with clinical pharmacists and community health workers as both 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 preeclampsia risk reduction. 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 pregnancy ended in miscarriage, and her third pregnancy 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 OBGYN.

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 non-medical 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 the pharmacy staff; however, most referrals have been generated 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.

Figure 1 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 the availability of pharmacy providers 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, this was 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 OBGYN. 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. Dilworth G. Mississippi’s health report card highlights room for improvement in infant mortality, obesity. Mississippi Today. January 21, 2026. Accessed February 10, 2026. https://mississippitoday.org/2026/01/21/mississippis-health-report-card/?utm_source=chatgpt.com

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