(Radio Iowa) – A new report has found 33 Iowa counties are considered maternity care deserts. The report from the March of Dimes defines a maternity care desert as a county with no OB/GYNs and no hospital with a maternity ward. Jessica Dill, a manager with the March of Dimes, says Medicaid reimbursement rates play a big part in why many rural hospitals are closing their labor and delivery units.

“Hospitals can’t afford to stay open in places where the majority of families are coming to them with just Medicaid and not private care insurance,” Dill says. The state’s Medicaid program covered more than 40 percent of the births in Iowa in 2021. Mothers and babies in maternal care deserts face higher risk of poor health outcomes according to the March of Dimes report.

“Issues related to birth, maternal morbidity rates go up when families have to drive more than 30 minutes to get to a care provider,” Dill says. Dill says increased access to telehealth services could help give people in maternity care deserts more options to access care. The March of Dimes has found the number of babies born prematurely has increased over the past decade in Iowa.

According to the American Medical Association, the maternal death rate in Iowa more than doubled between 1999 and 2019.