# Maternal Health



Iowa maternal health policy priorities for 2025

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

With the Iowa legislative session beginning January 13, it is time for a rundown of important maternal health policies that should become priorities for state lawmakers in 2025.

Since I am focusing on access to midwifery care, it is worth noting that in October 2024 the World Health Organization issued a new position paper on “Transitioning to Midwifery Models of Care.” That paper offers an international definition by describing the guiding principles of midwifery models of care and reviewing the advantages of adopting them. 

According to the World Health Organization’s position paper, 

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The 24 most-viewed Bleeding Heartland posts of 2024

As each new year begins, I enjoy looking back at the posts that resonated most strongly with readers in the year that ended. Some things never change: actions by the Republican-controlled state legislature and Governor Kim Reynolds—especially attacks on public education—inspired many of Bleeding Heartland’s most-viewed posts from 2024. That’s been true every year since the GOP trifecta began in 2017. U.S. Senator Chuck Grassley, who featured prominently in two of last year’s most popular posts, makes another appearance below.

I’ve learned there is no way to predict which pieces will take off. Some of the posts linked below required intensive research and days of writing, while others took only a few hours from start to finish. One was among the longest I wrote last year (more than 5,000 words), while another was among the shortest (fewer than 300 words).

Some authors whose work gained a large following in past years made the list again. But three authors featured below were contributing to Bleeding Heartland for the first time.

This list draws from Fathom Analytics data about total views for 561 posts published from January 1 through December 31, 2024. I wrote 145 of those articles and commentaries; other authors wrote 416. I left out the site’s front page and the “about” page, where many people landed following online searches.

A half-dozen posts barely missed the top 24, by a few hundred views or less:

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Your body, my choice: The medical model of maternal health care in Iowa

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

As the phrase “your body, my choice” has infiltrated social media in the days following the 2024 presidential election, Linda Crownover-Inch, the International Cesarean Awareness Network (ICAN) of Quad Cities chapter leader and a doula, posted the following on Facebook:

There is one place where this phrase has been accepted and normalized for decades and will not disappear until people rise up and face it head on. That place is in the medicalized maternity care setting.

In my experience as a seasoned doula, every one of the medical maternity care providers (OB’s and medicalized midwives) that provided labor and birth service for my client’s, have violated my clients right to bodily autonomy in ways that should be categorized as assault.

Sadly, US medicalized birth culture has normalized assault during labor and birth as “That’s just the way it happens” and “They need to do those things to me to make labor and birth safe”, or “I can’t tell them what to do”. Too often I’ve stood in circles of people retelling, All the while normalizing trauma and assault in their medicalized birth stories.

While I’m sure many will balk at applying this horrendous saying to standard maternity care in most of the United States, Linda’s post resonated with my experience as a maternal health advocate in Iowa. The current reality is that most women seeking prenatal, birth, and postpartum care in Iowa face inadequate care options and degrading experiences, all in the name of so-called health care. 

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Maternal health questions for Broadlawns trustee candidates

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

In August, I spoke to the Broadlawns Board of Trustees for the third time in the past four years.

You can read my comments from my first time speaking during their citizen comment period in July 2018 when I was five months pregnant and looking for VBAC supportive care for the birth of my second child. Unbeknownst to me at the time, this experience launched my maternal health advocacy.

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Midwifery licensure would improve maternal health, infant outcomes

Bethany Gates is a Certified Professional Midwife from Vinton (Benton County), where she lives with her husband, Judah, and their 4 daughters.

Certified Professional Midwives are midwives who practice in an out-of-hospital setting. Iowa CPMs attend home births; in other states, CPMs attend home births and births in birth centers. 

Here in Iowa, CPMs are unregulated, and the Iowa Code does not have any section addressing their practice. While this may sound like freedom in theory, the reality is that midwives face many challenges as they strive to provide quality care, because Iowa does not license the profession.

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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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