Access to maternal health care is becoming increasingly limited in rural Iowa. More than one-third of Iowa’s counties are now considered maternity care deserts, meaning they have no hospital or birth center offering obstetric services and no obstetric providers. Even in areas with some access, challenges such as workforce shortages, transportation barriers, and lack of specialty care can delay or prevent needed treatment.

Challenges Facing Rural Communities

Rural hospitals across Iowa face mounting pressure to maintain labor and delivery services. Many have been forced to scale back or close these services due to financial strain, staffing difficulties, and lower birth volumes. As a result, pregnant individuals often travel long distances for prenatal, delivery, or postpartum care—putting both maternal and infant health at risk.

These challenges are intensified by social and structural factors, including:

  • Limited access to behavioral health and substance use treatment

  • Housing instability and transportation gaps

  • Racial and ethnic disparities in health outcomes

  • Higher rates of chronic health conditions

Efforts to Improve Maternal Health

State and local partners are working to address these gaps through a range of strategies:

  • Supporting rural hospitals with maternal care infrastructure and emergency readiness tools

  • Expanding access to telehealth for prenatal and postpartum care

  • Strengthening the maternal health workforce, including midwives and community health workers

  • Participating in quality improvement initiatives such as the AIM program and perinatal collaboratives

Our Commitment

The Iowa Rural Health Association (IRHA) is dedicated to improving maternal health outcomes and advancing equity for all rural families. We support collaborative efforts that ensure every Iowan—regardless of where they live—can access safe, timely, and high-quality maternal care.

AIM Obstetric Emergency Readiness Kit


The AIM Obstetric Emergency Readiness Kit is a collection of best practices designed to help healthcare teams prepare for and respond to serious obstetric emergencies. Developed by the Alliance for Innovation on Maternal Health (AIM), the kit’s primary purpose is to support appropriate, timely care in settings that may not routinely provide obstetric services. This includes rural hospitals, emergency departments, and clinics with limited resources or staffing.

The kit includes clinical protocols, supply and medication checklists, simulation tools, and team communication guides. It promotes consistent, evidence-based care and strengthens readiness across the healthcare team.

Why it matters for rural Iowa:
In many rural communities, obstetric care is limited or no longer offered on-site. This resource is especially valuable for facilities that may only occasionally encounter pregnant or postpartum patients but still need to be prepared to respond to emergencies such as hemorrhage, hypertension, sepsis, or embolism. The kit provides a practical roadmap to improve maternal safety and support participation in perinatal quality improvement initiatives.

How to Access the Kit:
All materials are available free of charge at the AIM website. Facilities can download the toolkit, access emergency-specific guidance, and find resources tailored to different care settings.

IRHA encourages rural providers to incorporate this toolkit into their emergency preparedness plans to improve maternal outcomes across Iowa.