From Senator Rich Taylor

Written by Theresa Rose on November 6, 2019

How can we ensure healthy moms and babies?

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. Southeast Iowa has been hard hit. Jefferson County Health Center, Keokuk Area Hospital, Washington County Hospitals and Clinics, and Van Buren County Hospital 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 southeast Iowa where, in 2018, 58% of Lee County births were covered by Medicaid; 43% in Henry County; 53% in Jefferson County; and 35% in Washington 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!




Additional information

This is a legislative update from State Senator Rich Taylor, representing Henry and Lee counties and portions of Washington and Jefferson counties. For bio, photos and further information, go to

To contact Senator Rich Taylor when the Legislature is in session, call the Senate Switchboard at 515-281-3371. Otherwise he can be reached at 319-931-1568. E-mail him at

Senator Rich Taylor is an Assistant Leader. He serves on the following committees: