Labor & delivery unit closures most impact travel times to birth locations for micropolitan residents in Iowa

Purpose Continued closure of rural hospitals and labor & delivery units can impact timely access to care. Iowa has lost over a quarter of its labor & delivery units in the previous decade. Calculating how travel times to labor & delivery services have changed, and where in the state the largest travel times take place, are important for understanding access to this critical service. Methods Using parental address and facility location from birth certificate data in Iowa from 2013 to 2019, travel times to birth facility are assessed for rural, micropolitan, and metropolitan parents, as well as for complicated versus noncomplicated births and Medicaid versus non-Medicaid recipients. Findings Parts of the state have travel times that are consistently greater than 30 minutes over the duration of the study. The largest increases in travel times are found among micropolitan residents, particularly those experiencing complicated births. Travel times are consistently the longest for rural residents but increased only slightly over the study time period. Conclusions These findings suggest that access to hospital-based obstetric care is most changed for residents of small towns rather than rural or larger city residents.

Automated summary

The closure of rural hospitals and labor & delivery units has impacted access to timely care. In the past decade, Iowa has lost over a quarter of its labor & delivery units. The study found that certain areas in the state consistently have travel times exceeding 30 minutes.