Welcome 

Kelly Garcia
Director of Iowa Health and Human Services

The Landscape of Iowa Birthing Centers 

Stephen Hunter, MD, PhD
Maternal-Fetal Medicine Specialist, University of Iowa Hospitals & Clinics  

Learning Objectives:

1. Review the current state of maternity services in Iowa Hospitals.
2. Discuss the impact of maternity service closures.
3. Review continuing challenges to maternity care in Iowa.

Setting the Stage: Research on Birthing Center Closures and Next Steps

Heather Rouse, PhD
Assistant Professor of Human Development and Family Studies and Director of 12D2 - Iowa’s Integrated Data System for Decision-Making  

Learning Objectives:

1. Review the unique challenges rural communities face in Iowa due to birthing center closures, such as increased travel distances, limited prenatal and postnatal care options, and potential adverse health outcomes for mothers and babies. 
2. Analyze available data and research on the long-term effects of birthing center closures in rural Iowa, including maternal and infant mortality rates, birth outcomes, and healthcare disparities, to emphasize the urgency of addressing this issue and advocating for sustainable solutions. 
3. Summarize the next steps regarding data and evaluation of this project - including additional data on birth outcomes in rural Iowa during Covid. 

Bridging the Gap: Innovative Clinical Approaches

Jill Henkle, RNC-OB (Moderator)
Iowa Statewide Obstetrics Mobile Simulation Team

Lastascia Coleman, CNM, ARNP, MSN, FACNM
Certified Nurse-Midwife, University of Iowa Hospitals & Clinics  

Joel Wells, DO
Departmental Chief of Service for Cardiac Rehab, Health Information Management, Obstetrics, Pediatrics, and QA/QI Infection Control, Wayne County Hospital & Clinic System

Learning Objectives:

1. Discuss the role of midwifery care in rural communities.
2. Review the UIHC Nurse-Midwifery Education program and what impacts we plan to have on the state.
3. Examine pregnant women's challenges in rural communities and illustrate how a residency program can address these issues. 
4. Assess and determine answers to questions regarding solutions to maternity and neonatal care - if not us, then who, and if not now, then when? 

Access to Maternity Care and Evidence-Based Supports for Maternal and Infant Health in Rural Areas: The Role of Geography and Equity

Julia Interrante, PhD, MPH
Research Fellow and Statistical Lead, University of Minnesota Rural Health Research Center

Learning Objectives:

1. Describe the status and consequences of declining access to hospital-based obstetric care across rural communities in the United States.
2. Examine the availability of evidence-based support for maternal health care in rural communities with and without hospital-based obstetric care.
3. Delineate racial and ethnic differences in rural access to maternity care and evidence-based support for maternal health.

Lunch

Maternal Morbidity and Mortality in Iowa: Root Causes and Key Opportunities

Robert Kruse, MD, MPH, FAAFP (Moderator)
Iowa State Medical Director

Elizabeth Matney (Moderator)
State Medicaid Director, Iowa Department of Human Services

Panel Participants: 

• Domestic Violence: Monica Goedken, Violence Prevention Coordinator
• Family Planning: Lindsey Jones, MHA, Title X Family Planning Director
• Breastfeeding and Nutrition: Nicole Newman, RD, LD, CLC, State WIC Breastfeeding Coordinator
• Maternal Mental Health: Steph Trusty, RN, BSN, Maternal Mortality Review Committee Coordinator 

Learning Objectives:

1. Identify the leading causes of maternal morbidity and mortality in Iowa.
2. Describe the Iowa Maternal Mortality Review Committee's process to review cases and provide recommendations.
3. Describe the socio-ecological model and how it can be applied to Iowa's maternal morbidity and mortality efforts.
4. Describe upstream policy and programmatic interventions impacting maternal morbidity and mortality in Iowa.

An Intersectional Look at Prevalence, Causes, and Policy Solutions for Maternal Morbidity and Mortality in Rural Communities

Julia Interrante, PhD, MPH
Research Fellow and Statistical Lead, University of Minnesota Rural Health Research Center

Learning Objectives:

1. Describe differences in maternal morbidity and mortality across intersections of rurality, race and ethnicity, and income.
2. Examine causes of maternal morbidity and mortality, including intimate partner violence and care content across the perinatal period, and how those differ across intersecting patient identities. 
3. Describe policy options for addressing overall prevalence and disparities in maternal morbidity and mortality in rural communities, including postpartum Medicaid extension, data collection and reporting, and universal screening.

Break

Community-Based Solutions: Panel Discussion

• Nine2Thrive: Hannah Rivas and Stephanie Cassady 
• Count the Kicks: Christine Tucker, Health Equity Coordinator
• Doulas: Jazzmine Brooks, Iowa Health and Human Services Doula Project + Rural Black Doula
• Home Visitation: PJ West, MIECHV Deputy Director/Early Interventions and Supports Division of Family Well-Being and Protection, Iowa Department of Health and Human Services

Learning Objectives

1. Explore community-based organizations that are addressing maternal health challenges in rural areas. 
2. Share evidence-based research and real-world experiences that demonstrate the effectiveness of CBOs in improving maternal health outcomes in rural areas.
3. Identify barriers and opportunities for scaling up successful community-based interventions and programs to further enhance maternal health outcomes in rural areas. 

Closing the Gap: Policy and System Changes for Maternal Rural Health

Stephen Hunter, MD, PhD
Maternal-Fetal Medicine Specialist, University of Iowa Hospitals & Clinics  

Learning Objectives:

1. Review potential solutions to the maternity care crisis in Iowa.
2. Demonstrate the potential benefits and positive outcomes of these initiatives discussed throughout the day.
3. Foster dialogues and generate actionable recommendations for policymakers, funders, and healthcare stakeholders to support and invest in evidence-based solutions for maternal health in rural Iowa. 

Adjourn