The following is a legislative update from State Senator Amanda Ragan, representing Franklin, Butler and Cerro Gordo counties from Senate District 27:
Among Iowa’s health care challenges is rural access to maternal care—pregnancy, labor and delivery, and postpartum.
Population shifts mean fewer babies are born in rural communities, so it becomes increasingly difficult to offer the necessary services there.
As a result:
- Most rural hospitals have no obstetrician on staff. Iowa ranks 50th among the 50 states for OB/GYNs per capita.
- Many rural hospitals no longer deliver babies. North-central Iowa has been hard hit. Mercy Medical Center in Hampton, Mitchell County Regional Health Center in Osage, Eldora Regional Medical Center and Ellsworth Municipal Hospital in Iowa Falls have closed their OB units.
- Some Iowa women must drive hours to a hospital equipped to deliver babies.
- Iowa has a high rate of cesarean births (32 percent), which can lead to future health problems.
The outcomes for patients are striking.
In less than three years, Iowa’s maternal mortality rate has more than doubled, claiming the lives of 48 women. In addition, in the last two years, more than 40 women lost their uteruses in Cesarean-Hysterectomies at one hospital alone.
Of Iowa hospitals that have stopped delivering babies, the difficulty attracting and retaining skilled medical professionals was the main reason. Also playing a role are financial concerns. Malpractice insurance is more expensive for doctors who deliver babies, and fewer rural patients needing maternal care make labor and delivery too expensive for aging communities.
In addition, privatized Medicaid doesn’t cover the costs for delivering babies if health care providers follow the recommended standard of care. That can really take a toll in our area where, in 2018, 36% of Butler County births were covered by Medicaid; 47% in Cerro Gordo; and 54% in Franklin County.
Here are some steps the Legislature could consider to make Iowa safer place to have a baby:
- Adjust Medicaid rates so that hospitals are adequately reimbursed for the care they provide.
- Reverse course on policies that closed family planning offices so that all Iowa women have access to services close to home.
- Ensure labor and delivery units use proven practices—known as “safety bundles”—that save lives during delivery.
Do you have a personal maternal health care story that could help me make the case at the Iowa Capitol? If so, I’d like to hear it!