Iowa Nurse Midwives Fill Gap in Prenatal Care After Rural Hospitals Shut Down Delivery and Labor Units

Bailee Tordai Prenatal Checkups Iowa Nurse Midwives University of Iowa Muscatine Washington birthing units

By Joel Brussels , Parent Herald Jul 16, 06:18 am

Photo: (Photo : Cindy Parks from Pixabay )

Bailee Tordai has a major problem on her hands. The 22-year-old, who was 33 weeks into her pregnancy, barely made it to her prenatal checkup as her old Jeep could not complete the two-mile trip from her house to the University of Iowa's outreach clinic in her southeastern Iowa hometown of Muscatine.

She is growing concerned about her lack of reliable transportation as she gets closer to her due date. CNN reported that Tordai would need to arrange for someone to drive her about 40 miles northwest to the University of Iowa Hospitals and Clinics in Iowa City as she can't give birth at Muscatine's hospital because it shuttered its birthing unit back in 2020.

Tordai is fortunate that 11 certified nurse midwives from the University of Iowa regularly travel to Muscatine and Washington, another southeastern town in Iowa where the local hospital closed its birthing unit.

The midwife team provides valuable service to pregnant Iowans

According to the Daily Iowan, the university's pilot project, which is supported by a federal grant, does not aim to reopen shuttered birthing units in Iowa. Instead, the midwife team helps ensure women in the area receive related services. The project was a tremendous help for pregnant women in the region as it served more than 500 patients in Muscatine and Washington last year.

Muscatine is one of the hundreds of rural areas in the United States where hospitals have dropped birthing services during the past 20 years, often because they lack specialized staff members and obstetricians.

According to hospital industry leaders, birthing units tend to lose money, largely because of low payments from Medicaid, the public health insurance program that covers more than 40 percent of births in the United States, and an even greater share in many rural areas.

Rural hospitals in Iowa are closing their birthing units

The loss of labor-and-delivery services hits especially hard for American women who lack resources and time to travel for care. Muscatine has a population of more than 23,000 residents, making it a relatively large town by Iowa standards. Muscatine's hospital, though, is one of 41 facilities in the state that have closed their birthing units since 2000, according to the Iowa Department of Public Health. The majority of those are located in rural areas. Only 56 hospitals now have birthing units in Iowa.

The work of the nurse midwife team is vital as it includes crucial prenatal checkups. Most pregnant women are supposed to have a dozen or more such appointments before they give birth. Health care providers use these prenatal checkups to track how a pregnancy is progressing and to watch for signs of high blood pressure and other problems that can lead to stillbirths, premature births, or even maternal deaths. Midwives also advise pregnant women on how to keep themselves and their babies healthy after giving birth.