Health professionals in Iowa discuss viable solutions to growing maternal mortality and pregnancy problems. Iowa’s Department of Health and Human Services Director Kelly Garcia spoke to lawmakers on maternal death and serious complications prevention programs. National measures show a worrying trend in state maternal health.
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Rising Mortality Rates Spark Urgent Measures Amidst OB-GYN Shortage
Iowa’s maternal and newborn mortality rates have increased, especially in places where birthing units have closed, restricting prospective mothers’ prenatal care. In seven counties where labor and delivery units closed, pregnant women had trouble getting care, according to a University of Iowa research. In 2023, the March of Dimes called a third of Iowa’s counties “maternity care deserts,” without hospital birthing centers or OB-GYNs.
To address this, policymakers funded rural family medicine obstetrics fellowships and created “Centers of Excellence” to improve health system coordination. Iowa still lacks OB-GYNs per capita, aggravated by new abortion restrictions.
Dr. Robert Kruse, state medical director, highlighted maternal health improvement in central, western, and southwest Iowa. Rural “Centers for Excellence” like Grinnell Regional Medical Center and St. Anthony Regional Hospital expand maternal mental health, perinatal care, and obstetric outreach clinics.
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Patient Safety ‘Bundles’ Bring Hope Amid Challenges
Garcia mentioned patient safety “bundles” for 56 hospitals with open labor and delivery facilities. These packages improve delivery safety, reduce low-risk cesarean birth rates, and address inequities with evidence-based best practices. However, 2023 provisional data shows rates above national norms.
The agency may require Iowa Medicaid-funded facilities to join the patient safety bundle program. To reduce unnecessary severe maternal morbidity and mortality in Iowa, state officials are considering a hospital-directed payment program directly related to outcome indicators.
Recent abortion bans are making it harder for officials to recruit and retain OB-GYNs. Despite these challenges, Garcia is determined to change Iowa’s maternal health system, emphasizing the need for continual efforts to make motherhood safer.
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