Bill would seek to improve rural maternal health care in Iowa


A bill in the Iowa Senate would try to address issues with rural women’s health care.

Lauren Ratliff

With growing concern around maternal health in Iowa, Senate Democrats have decided to take action.

“Our maternal mortality rate has more than doubled in the past three years; labor and delivery departments are shuttering at record speed; and 66 Iowa counties no longer have a single practicing OB/GYN,” said Sen. Janet Petersen, the Iowa Senate Democratic leader, in a press release.

18 members of the state Senate have proposed a solution to address maternal health. The Healthy Moms and Babies Act aims to adjust Medicaid rates to allow mothers to be reimbursed for their treatments, ensure labor and delivery units use safe practices and also would expand home visiting services for women and their babies.

Iowa has the lowest number of obstetricians per capita in the country, which is a contributing number to the United State’s maternal death rate, according to the Senate Democrats’ press release, while the U.S. has the highest maternal death rate of all developed nations, according to a ProPublica and NPR investigation.

In addition to this, 64 percent of level one rural hospitals have no obstetrician on staff and 66 of Iowa’s counties do not have a single OB-GYN practicing in their county.

Access to services and facilities to help solve this issue are also becoming more scarce. As of October 2019, Iowa has seen 37 of their 118 hospitals close their birthing units. Two closures occurred in 2019, down from the eight that occurred in 2018.

About 40 percent of births in Iowa are paid for through Medicaid, which is one of the reasons the proposed bill is hoping to adjust rates. The Medicaid proposal plans to provide reimbursement for labor and delivery costs, allow continuous Medicaid coverage for 12 months postpartum and provide reimbursements for postpartum care products, breastfeeding supports and transportation to and from prenatal and postpartum appointments.

To enforce safe practices for labor and delivery units, the bill proposes that licensed hospitals that provide labor and delivery units implement the best practices that are recommended by the American College of Obstetricians and Gynecologists and the Alliance for Innovation on Maternal Health. Some of these practices include safety bundles for severe hypertension, postpartum care and other specialized plans.

The Department of Human Services plans to collaborate with the Department of Public Health and the Department of Education to help grow maternal and infant home visiting services. The plan will include promotion of healthy pregnancies, positive birth outcomes and healthy infant growth and development.