Iowa faces shortage of doctors to deliver babies as hospitals cut labor and delivery

SHENANDOAH, Iowa (KMTV) — There aren't enough doctors to deliver babies in Iowa.

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At the Shenandoah Medical Center, Dr. Martee MacLeod-Kozal says some of her patients drive more than an hour to get there.

She is currently the only full-time OB-GYN at Shenandoah Medical Center. Other providers help cover the on-call and clinical schedules. But a lot of Iowa's rural hospitals don't have any labor and delivery.

"So, the next closest hospital to here (with labor and delivery) is Creston, which is about an hour and 20 minutes," MacLeod-Kozal said.

When asked what worries her about the distances patients travel, she pointed to the risk of emergencies.

"Yeah, I mean, obviously there can be emergencies where that time is a big deal. So, you know, we try to give people really good precautions for the things to come in for and what to call for," MacLeod-Kozal said, noting that her job involves a lot of planning.

In Iowa, communities are not mandated to provide ambulance services and there is a shortage of EMS volunteers.

Jenny Sharrick is the director of public health services for Firefly, a nonprofit that serves young families with lower incomes. She worries about the shortage of EMS workers.

"If they are helping somebody else, and there is a recently postpartum person who is maybe hemorrhaging and the EMS can't get to them, to then take them 45 minutes to the hospital — that's a real concern for maternal mortality," Sharrick said.

According to the American Medical Association, 57% of Iowa counties don't have an obstetric facility. There are fewer OB-GYNs per capita than the national average; Iowa has 3.3 ob-gyns per 10,000 women of reproductive age when the national average is 4.5 per 10,000 women.

"Unfortunately, being an OB is just kind of hard," MacLeod-Kozal said.

"There are fewer OB-GYNs to get daily care, there are fewer birthing centers, there are — those long distances to travel and there are EMS that are, like short, and you just keep adding on," Sharrick said.

MacLeod-Kozal says labor and delivery units are expensive to run.

"It's keeping ob-gyns willing to do it and keeping hospitals willing to be supportive of it," MacLeod-Kozal said.

Shenandoah Medical Center started its own ambulance service to address some of the need. Also, she says, an overnight nurse-midwife helps alleviate staffing issues.

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