In August 2023, the national nonprofit organization March of Dimes — dedicated to improving the health of mothers and babies in the U.S. — released a report designating a third of Iowa’s counties as maternity care deserts, meaning they have no obstetrics and gynecology services or birthing hospitals.
Between 2020-21, eight Iowa hospitals saw the closure of their labor and delivery units, and 40 more were at risk of total closure in 2022 due to low or non-existent financial reserves and a negative financial margin over three years.
According to March of Dimes, the farther a woman travels to receive maternity care, the higher the risk of maternal morbidity and poor outcomes for infants. In Iowa, 14 percent of women live more than 30 minutes from a birthing hospital compared to the U.S. average of 9.7 percent.
One way this care disparity is being combatted is by midwives. A licensed Certified Nurse Midwife can provide care for clients from puberty through menopause. Care can include, but is not limited to, annual physicals, preconception and contraception education, and birth.
Megan Swanson, a first-time mother in Cedar Rapids, Iowa, gave birth to her first child in her and her husband James’ home in September. Moira Weitz and Allie Kubik, Midwives with Rooted In Love Midwifery, served as Swanson’s midwives and provided care for her throughout pregnancy, delivery, and postpartum.
Swanson said after meeting with Weitz and Kubik for the first time that she put all of her trust into them, “They were my main care providers, and then they would refer me elsewhere if I needed an ultrasound or lab work done or anything like that,” Swanson said. She said along with relying on her midwives for clinical care, she formed a strong emotional bond with them, “They cared about me as a whole person. So I felt really close to my midwives,” she said, “I just felt like the birth experience was so empowering. And I would do it all over again in a heartbeat,”
Israel Heckart, 2, sits on a toy horse outside of the Best Budget Inn in Marshalltown, Iowa on Monday, Sept. 25, 2023. The Heckart family lives in and operates the motel. Israel is one of four children. All four of her children were delivered at home with the assistance of a midwife, and his mother Analee Heckart intends for the same with her fifth.