Moms worried as more obstetrics units closing across Iowa

Summer days at a small-town park are part of the Iowa dream for Mira Daniels and her family.

“I was born and raised in Iowa, and I wanted to raise my kids here,” she said. “I was raised in a small town, and I wanted to raise my kids near my family.”

Daniels, her husband and her two sons live in Fairfield, which has a population of about 10,000 people, but that small-town life became a much bigger problem when her kids were born.

“We didn’t actually have an obstetrics program at our local hospital. Our closest one was maybe half an hour away, but we actually went with one in Iowa City, which was an hour drive for us,” Daniels said.

That drive was so far away that Daniels said she almost didn’t make it to the hospital in time to give birth to her second son.

That’s an issue expectant mothers in Marshalltown could soon face.

UnityPoint Health - Marshalltown recently announced its obstetrics unit and women’s health clinic will close for good September 30.

In a statement, UnityPoint Health attributed it to a 45 percent decrease in births at the hospital over the last six years. This past March, the hospital said only 18 babies were born there, which was the smallest number of deliveries in a month in its history.

At the end of September, UnityPoint Health - Marshalltown will become the 34th Iowa hospital to close its obstetrics unit since 2000. On that long list are other hospitals in eastern Iowa, including Jones Regional Medical Center in Anamosa, Mercy Medical Center in Dyersville, Guttenberg Municipal Hospital, Jackson County Regional Health Center in Maquoketa, Washington County Hospital and Clinics in Washington, Mercy Hospital of Franciscan Sisters in Oelwein, and Buchanan County Health Center in Independence.

Before 2001, there were maternity services in 75 of Iowa's 99 counties, according to the Iowa Medical Society. That number has now dropped down to 51 counties, barely half the counties in the state.

But it isn’t just a problem in Iowa.

“It is a national phenomenon over the last 10 to 15 years,” Keith Mueller, who serves as the head of the Health Management and Policy Department at the University of Iowa’s College of Public Health, said.

Mueller is also the director of the Rural Policy Research Institute and a national expert on rural health policy. He said when rural hospitals close completely or partially, it’s usually because of finances.

“The hospital cannot meet payroll if you will,” Mueller said.

Mueller said there’s a proven relationship between a community losing its obstetrics services and a decrease in its quality of care, according to a study from the University of Minnesota.

“It’s more common when it’s a more remote location that loses the OB unit, so the more remote, the more dire, I guess, the consequences are in individual health,” Mueller said.

That’s a compromise Daniels believes no mom or family should have to make.

“It was balancing my desire to have a family in the community that I wanted to and that I grew up in, and being able to have the resources that my family needs, so it’s a tough choice,” Daniels said.