A League of Her Own: Olivia Walton Shakes Up the Status Quo

During a pivotal moment of the Aug. 21 Arkansas Maternal Health Roundtable at Crystal Bridges Museum of American Art in Bentonville, host Sen. John Boozman fielded a question about the inadequacies of current medical reimbursement to health care organizations affecting patient care, especially among low-income patients. Boozman’s answer walked the crowd through a series of challenges on the issue packaged neatly in senatorial lingo.

 

At the conclusion of his answer or perhaps half a beat before, Olivia Walton launched the follow-up seemingly everyone in the audience was thinking: “So what do we do about it?”

The moment, while respectful in all aspects, was telling. Walton, a highly successful in-law to the dynastic Bentonville family behind Walmart, is not one to sit still on the issues that move her, be they art, business or, of late, the state of Arkansas’ maternal health care.

 

“I have three kids. I’ve had two of them down here in Arkansas, and I had the last one up in New York City,” she said during an exclusive sit-down interview with AY About You. “I had good care here in Arkansas, and still, the experience was really different. Having a baby down here really opened my eyes to what a lot of women were going through and just how much help I needed, even in a hugely privileged position.

 

“You know, I am so fortunate to be in the family that I’m in, a family that has a deep belief in doing something because you can and leading. We live here, and we want to make a difference, and the issues we work on affect the people we love and care about and live next to. [Maternal health] was just right along those lines.”

 

Walton’s activism on the topic comes at a pivotal moment in the state’s history, one in which the northwest corner of the state, an area defined in no small way by the Walton family, is growing at rocket speed on new ideas. At the same time, communities in the Delta and points east have struggled to coax the same ideas into reality, none more pressing than deficient or absent health care.

 

Specific to maternal health, Arkansas falls well short of par by nearly every assessment out there. The state ranks last in the nation on maternal mortality at 43.5 deaths per 100,000 live births, the nonprofit Arkansans for Improving Maternal Health states. Of those deaths, the organization notes, 92 percent could have been prevented with proper care, yet with nearly half of Arkansas counties lacking a single obstetrics provider, access to even the most basic prenatal care is a monumental challenge.

 

The Bentonville roundtable was the second held in Arkansas this year, signifying the emphasis lawmakers and state leadership are giving to the issue. Asked about the tone and turnout of the event, Walton, while expressing gratitude for the attention to the issue, leaned in on what action should come next, echoing again, “So what do we do about it?”

“My understanding of what’s going on down here in Arkansas has been growing, I think, from the moment I tried to get pregnant,” she said. “What I’ve learned along the way is that we really do know how to tackle this crisis. There are lots of places doing it better. There are programs that work. There are policies that work. We just need to run those playbooks down here in Arkansas, and we’re not doing that quite yet.”

 

Maternal health activist is just one of the titles Walton has worn during her career, and while she may not have envisioned the specific arenas in which her life would play out, there is no doubt she was destined to accomplish big things. Born in New York into a line of strong, accomplished female entrepreneurs — her mother was an art dealer and her grandmother, a business owner — she was invested with a rare sense of what was possible in life.

 

“I wrote my college admissions essay about wanting to run the Metropolitan Museum of Art in New York,” she said.

 

Walton completed a double major in history and political science with a minor in art history at the University of Pennsylvania, then attended graduate school at the London School of Economics and Political Science, completing what she described as a global political economic degree. The first act of her career played out in journalism, and she worked as a business correspondent for NBC News and MSNBC and as an anchor for Bloomberg Television in New York and London.

 

In every chapter of her professional life that was to follow —  including, currently, chairperson at Crystal Bridges, executive board chair of the Momentary, founder of Ingeborg and co-founder of the Heartland Summit, all in Bentonville, as well as her health advocacy work — her journalism background has been leveraged to great aplomb.

 

“I have always loved storytelling,” she said. “I think that’s the real connection between journalism and working at the museum. What the museum’s really trying to do at its core is lift the voices and stories of artists to tell a fuller story of the history of American art and thus the history of America.

 

“That’s kind of what you’re doing with pulling together a group of people for a talk about maternal health. You’re trying to tell that story and raise awareness, so storytelling’s kind of been the solid line throughout.”

 

Another theme that has run from her childhood taproot throughout all of her current ventures is lifting women, be it through financial acumen, professional opportunity or health. Her company, Ingeborg, monikered after her grandmother, fulfills those goals through Ingeborg Investments, which seeks investment opportunities that have venture-scale potential and empower women by filling gaps in opportunity, access, equity or experience, and Ingeborg Initiatives, which seeks to improve outcomes for women in other ways, be it maternal health or, Walton’s other mission targets, improving paid leave and financial empowerment.

 

The interrelatedness of the missions is undeniable. Statistics show the more financially stable a woman is, the better health care she tends to have access to, for example, just like poorer women’s diet and lack of medical access feeds more negative outcomes.

 

Given how closely a mother’s health and wellness impacts her pregnancy and, therefore, that of her family, it would be easy to broaden one’s view on myriad health issues at once. Walton said choosing to focus on maternal health specifically over equally significant issues such as the impact of smoking and diabetes or factors related to infant mortality was strategic, opening the doors to wider conversations by starting with the outer layer of a very large societal onion.

 

“I think once people start to realize that this is the most impactful point of intervention, it becomes obvious that we should be focusing on maternal health,” she said. “As Cara Osborne [senior fellow at Heartland Forward in Bentonville] said on the panel, that window during which you’re pregnant and right after you have the baby is the most consistent engagement you have with medical care at any point in your life.

 

“I mean, I went my entire 20s without going to the doctor. Suddenly, I got pregnant around 30, and then it felt like I’m at the doctor every two weeks. If you want to change the trajectory of a woman’s health or a family’s health, this is your best window of opportunity to do that.”

 

Walton’s crusade marches in two columns — improving access to medical care and the reimbursement of that care, particularly for low-income women. On the access side, she said models exist across the country and around the world of serving populations smaller, poorer and more remote than those in Arkansas — namely the deployment of doulas and midwives to underserved areas.

 

“A lot of countries with far less resources than we have are doing this,” she said. “There are states that are more rural than us. For example, Alaska — Alaska has, like, 30 times the midwives we do, and they have lots of places in Alaska to train to actually become a midwife.

 

“The doula piece is really important for individualized and more frequent care and what’s going on with that person because there’s lots of pieces that are nonmedical related to the health and well-being of the mother that are going on in that pregnancy period, so the solutions are within reach. We know how to do this.”

 

As for the financial piece, Walton acknowledged meaningful change cannot come without the cooperation of the statehouse. She said she was encouraged by the involvement in the issue of Boozman, Rep. French Hill and Gov. Sarah Huckabee Sanders, all of whom participated in the February roundtable.

 

“I believe one of the most important things [politicians] can do is reevaluate the reimbursement rate,” Walton said. “I think unbundling the reimbursement rate, raising the reimbursement rate, both those things are really where the rubber meets the road. Behaviors aren’t going to change until doctors and providers up and down that ladder are incentivized to offer better care.”

 

Sanders did not hesitate to follow up on the first roundtable with an executive order creating the Arkansas Strategic Committee for Maternal Health to provide input and support the development of a statewide strategic maternal health plan. Presented in September, the committee’s report provided a broad outline for addressing the factors contributing to maternal health — or lack thereof — providing a blueprint for improvement.

 

“I am grateful to the governor for her leadership on this issue,” Walton said. “At the end of the day, she is a mother of three children. She gets the importance of this stuff. I respect her so much for talking about her own experience with baby blues while she was in the White House. I mean, if anybody knows what’s going on with this stuff, it is Sarah Sanders, and so I think she’s perfectly suited to lead.”

 

Legislators and the medical establishment are not the only stakeholders that need to be moved to reconsider long-held attitudes about care. Walton said patients themselves must be educated about approaches that may differ from what has always been.

 

“I think that many people believe you could only have a safe birth in an emergency room or at the hospital with an [OB-GYN],” she said. “Listen, I’m a hospital girl. I had three epidurals, and I wouldn’t do it any other way, but there are lots of safe ways to have a baby at home in a lower intervention environment. That’s not right for everybody, but that is a piece of the puzzle here.

 

“If you’re having a noncomplicated birth, [midwives] are very well equipped to help deliver that baby in a really safe and effective way. They’re also really well equipped to refer someone to the specialist if something’s going on.”

Walton said she hoped audience members went home from the maternal health roundtable with kernels of new information, willing to take the discussion back to their local communities and decipher how they could begin to move the state toward better maternal health outcomes one company, one health system and one expectant mother at a time.

 

“I hope people went home and realized that they can do more,” she said. “If they are a private employer, there’s more things they can be doing for their employees. If they’re a private citizen, there are the things they can be doing to volunteer. If they vote, which I sure hope they do, there are things they can be demanding from their politicians, like having a place in the state to actually train to become a midwife.”

 

Walton said she would like to see more events held to continue the discussion and hold those in power accountable to move the agenda forward. Her grading curve — she said she wants to see the number of maternal deaths per 100,000 cut in half in the next five years — is aggressive yet commensurate with the importance of the mission.

 

“As a rural state, we’re never going to have the population density to support having an obstetrician and a delivery room in a hospital in every single county. That’s just not realistic,” she said. “That’s not the only way to have a safe birth, however, as you see in maternal mortality rates in much poorer countries and in other states, such as Alaska. What we need to have is this whole ladder of care built out so it’s not just an OB or nothing. There’s actually lots of levels of care that you can receive along the way where those rungs on that ladder are communicating with each other about the care of that patient.

 

“At the same time, we’ve done focus groups, and people don’t have any idea just how deep the crisis in maternal health is in Arkansas, so it starts with awareness. Until there’s awareness, patients aren’t going to demand better from their doctors or from their politicians.”

 

In the end, Walton said the key element necessary for the success of improving maternal health is a rejection of the problem as just a women’s issue, a campaign she is more than happy to spearhead on behalf of the families in her adopted home state.

 

“I feel really fortunate to be able to play a role in leading more and more awareness around this issue. I think that’s what it’s going to take to make real change,” she said. “I’m glad you’re talking to me about it today because I hope what that says is this is an urgent priority. It’s not just a women’s issue. Making sure Mom is healthy and financially secure is the single most impactful thing we can do to strengthen our families, to strengthen our communities and to strengthen our economies.” 

 

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