What Iowa's Maternity Ward Crisis Means for Polk County Women

Iowa leads the entire nation in closing maternity wards. That is not a statistic I expected to be writing about my home state. But here we are.

This week I published a deep dive on Medium about what is driving rural hospital closures across Iowa — the Medicaid reimbursement crisis, the abortion ban accelerating physician flight, the federal cuts threatening to push more hospitals over the edge, and a statehouse that has produced no meaningful response to any of it.

But I want to talk specifically about what this means for women in Des Moines and Polk County, because proximity to good healthcare can make it easy to feel like this crisis belongs to someone else. It doesn't.

Polk County Is Not Insulated From This

Des Moines has hospitals. Polk County women have options that most Iowa women do not. But Polk County does not exist in isolation — it sits at the center of a state where the healthcare infrastructure surrounding it is quietly collapsing.

Women who live in the counties bordering Polk County are already feeling this. Warren County. Madison County. Jasper County. Marion County. These are communities where families live and work within commuting distance of Des Moines, but where local healthcare access is thinning. When those women need emergency obstetric care, they are heading toward Polk County hospitals — adding pressure to a system that is not infinite.

And the workforce crisis is not staying rural. Iowa already has only 3.3 OB-GYNs per 10,000 women of reproductive age compared to the national average of 4.5. When medical students and residents choose to leave Iowa because of the abortion ban's legal uncertainty, that shortage does not only affect rural counties. It affects every woman in this state.

This Is a Women's Rights Issue

I want to be direct about something that gets lost in the policy language: this is a women's rights issue.

When a state passes an abortion ban so restrictive that OB-GYNs face criminal liability for good-faith medical decisions, and then watches its maternity care infrastructure collapse while doing nothing, that state has made a choice about how much it values women's lives. Iowa has made that choice visibly and repeatedly in recent years.

The women driving 45 minutes in labor on Iowa roads at 2 a.m. are paying for that choice. The women who skip prenatal appointments because the nearest provider is an hour away are paying for that choice. The women in Polk County who will eventually feel the ripple effects of a depleted statewide OB workforce are paying for that choice.

As a Des Moines, Polk County, Iowa woman I refuse to look away from that just because my nearest hospital is ten minutes away.

What You Can Do

If this makes you angry — good. Here is where to put that anger:

Contact your Iowa legislators. Tell them rural hospital stabilization funding needs to be a priority this session. Find your representative at legis.iowa.gov.

Contact Senators Ernst and Grassley. Ask them specifically what they are doing to protect rural Iowa hospitals from federal Medicaid cuts. Their contact pages are at ernst.senate.gov and grassley.senate.gov.

Read the full piece on Medium for the complete picture — the numbers, the named hospitals at risk, the policy failures at every level: Iowa Leads the Nation in Closing Maternity Wards. Nobody in the Statehouse Seems to Care.

Iowa women deserve better than this. Polk County women deserve better than this. And the women in every rural county surrounding us — the ones already driving an hour to deliver a baby — deserve better than the silence they are getting from the people elected to represent them.

Rebecca Nicole Schweitzer is a Des Moines, Polk County, Iowa writer and community advocate. Read more at iowaraisedrebeccaschweitzerunfiltered.com and on Medium, Substack, X, and Bluesky.