Rachel Bruns

Analysis: Five years of maternal health data in Iowa

Rachel Bruns is a volunteer advocate for quality maternal health care in Iowa.

I recently recounted how it took the Iowa Department of Public Health (IDPH) 170 days to respond to my request for information on the total births, primary cesareans, total cesareans, and vaginal births after cesareans (VBACs) at Iowa hospitals. I eventually received aggregated five-year totals (2016 through 2020) for each birthing hospital in Iowa.

The International Cesarean Awareness Network (ICAN) of Central Iowa, where I serve as a volunteer chapter leader, has made the data available on our website. You can see it in table form below as Appendix 1. 

While I would have preferred for IDPH to provide the figures for a single year, as I requested, the compiled data still tells us a lot about the overuse of cesareans at several Iowa hospitals and the lack of VBAC access across much of the state.

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State agency took 170 days to produce maternal health records

Rachel Bruns recounts the saga of trying to obtain records that the Iowa Department of Public Health could have provided promptly.

In an article I wrote for this website in January 2021, Provider practices in Iowa lead to more c-sections, complications, I mentioned that I had requested records from the Iowa Department of Public Health (IDPH) on the number of cesarean births and vaginal births after cesarean (VBACs) in Iowa hospitals.

A lot has happened related to my request since then. I’m summarizing my experience in case it can help other Iowans seeking what should be public information from a government entity.

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Provider practices in Iowa lead to more c-sections, complications

Rachel Bruns continues a series of posts addressing the quality of maternal health care in Iowa. -promoted by Laura Belin

My first post here addressed a number of outdated and non evidence based practices that continue in Iowa. My second post addressed how expanding access to midwives could help improve access to quality care, reduce the incidence of cesareans, and save lives.

This post will continue on those themes addressing additional practices of concern surrounding cesareans and vaginal birth after cesarean (VBAC).

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Iowa needs more midwives to save lives

Rachel Bruns continues a series of posts addressing the quality of maternal health care in Iowa. -promoted by Laura Belin

This article is all about midwives. I will be using this space to expand on four different needs in our state to improve the access and quality of maternal-child health care in Iowa. All of them are interrelated. If Iowa accomplishes these four things, we will see an improvement in maternal-child health outcomes across all races, accessibility of care options in all geographies, and an overall increase in quality and satisfaction from patients. 

The four areas I will address are:

  • The need to diversify our workforce and address birth equity (this is connected to the next 2 items)
  • The need to license Certified Professional Midwives (CPMs)
  • The need to expand access to Certified Nurse Midwives (CNMs).
  • The need to expand access to birth centers.
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    Maternal health in Iowa: You don't know what you don't know

    Rachel Bruns is a volunteer advocate for quality maternal health care in Iowa. -promoted by Laura Belin

    As I plan to write several posts in the coming weeks related to maternal-child health in Iowa, I want to introduce myself to Bleeding Heartland readers. For this piece, I’m going to provide some high-level information on the landscape around maternal health in Iowa from my perspective as a maternal-child health advocate.

    But first, some background on myself and how I became involved in this work.

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