T-R PHOTO BY MIKE D0NAHEY On Monday, a Clinic Closed sign is shown posted on the inside window of the UnityPoint Health-Marshalltown Women’s Center, 407 E. Main St. It reads, “The women’s health clinic and obstetrics unit closed permanently on Sept. 30.”

Editor’s Note: This is part two of a two-part series on changes in local obstetrics and gynecological services. Part one, which published Monday, reported on a decision by UnityPoint Health-Marshalltown to close its OB/Gyn unit and Women’s Center. Sunday’s report also examined how the local Primary Health Care office is working to meet the OB/Gyn needs of Central Iowa women.

A decision by UnityPoint Health-Marshalltown officials announced in August to close its OB/Gyn unit and Women’s Center which was effective Monday is part of a state trend of hospitals closing birthing units.

Since 2000, 34 of Iowa’s 118 community hospitals, including UnityPoint Health-Marshalltown, have closed their birthing units, according to the Iowa Department of Public Health. Most of those closures have happened at smaller facilities than the 49-bed Marshalltown hospital. Sixty-four Iowa hospitals continue to have maternity units, according to the state health department. Stephanie Trusty, a nurse who tracks birthing trends for the IDPH, said a shortage of obstetricians and gynecologists is a major reason for closures of birthing units. Iowa has one of the worst shortages in the nation, with 66 of the state’s 99 counties lacking any of the medical specialists, she said. Many doctors worry about keeping their skills sharp if they serve in hospitals that have declining birth numbers. Some patients decide it’s worth the drive to have their babies at large urban medical centers, Trusty said.

“Some of these birthing units are beautiful. They’re like a four-star hotel,” she said. Trusty said the most important question is whether the consolidation of birthing services affects the health outcomes. The state health department and the University of Iowa are monitoring that, and have not seen dramatic effects.

Birthing Centers and OB/Gyn Services Available

The nearest hospitals that still have birthing centers are in Grinnell, Newton and Ames, which are 30 to 42 miles away. However, officials with Primary Health Care which has OB/Gyn services in Marshalltown, but not a birthing center, said they were eager to serve all Marshalltown and Central Iowa women in need of those services. In February, PHC debuted its then newly-remodeled clinic at 704 May St. in Marshalltown as proof it was up to the task. PHC is headquartered in Des Moines, but provides health care services to several Iowa communities.

PHC-Marshalltown has served nearly 600 prenatal patients since 2016, according to Marissa Conrad of the organization. PHC’s OB/Gyn services at its May Street facility are available 8 a.m. to 5 p.m. M-F. Contact 641-752-4376 or phcinc.net.

Why Close Marshalltown Birthing Unit?

“There simply aren’t enough women choosing to deliver locally,” said UnityPoint Health President Jenni Friedly. “This is a problem that has been going on for a long time … there are enough women becoming pregnant, but they are going elsewhere to deliver. It’s clear OB/GYN patients are already selecting Ames and Des Moines for their care.”

Friedly said the local hospital had significantly relied upon the recommendations of three nationally known health care consultants to assess and evaluate data around services that are needed and supported.

“When it came down to it, our consultants said this was a service the community can not support,” she said.

“During the past six years there was a 45 percent decrease in the number of births at the OB unit, hospital officials said, and in March the hospital recorded the lowest number of deliveries – 18 – in its history.

Overall, the number of babies born at the Marshalltown hospital fell from 588 in 2012 to 446 in 2017, according to reports filed with the Iowa Hospital Association. In March 2019, the hospital recorded just 18 deliveries, leaders said. She also cited the inability to attract a second obstetrician as a significant factor in the closure.

Specifically Dr. MaryBeth Anderson joined UnityPoint Health-Marshalltown earlier this year as part of a plan to improve OB/Gyn services.

However, over time she became the sole OB/Gyn provider, and was on call frequently.

Optimism Abounded in February

Only six months previous to the August announcement to close the OB/Gyn unit, the UnityPoint Health Foundation initiated a fund-raising campaign to purchase badly-needed equipment for the Birthing Center.

$70,000 was raised quickly and hospital officials had reason to believe the community would respond positively, as it had done for a recent campaign to purchase badly needed ambulances for the “Keep Them Rolling Campaign.”

“Providing a safe and welcoming environment for birthing is one of the most important services a local hospital offers,” UnityPoint Health – Marshalltown Foundation board member and past president Kathy McCune said then. “Families value the opportunity to choose local when it comes to birthing for many reasons including quality of care, convenience, and family history.”

Based on McCune’s, testimonial and others, UnityPoint Health – Marshalltown Foundation embarked on the initiative to purchase state-of-the art equipment at the Birthing Center. Gifts to the campaign would support the hospital’s efforts to replace aging equipment and expand services for babies born as early as 34 weeks.

The hiring of Anderson was also part of this effort to expand services.

Friedly was excited in welcoming Anderson to the team.

“Anderson’s experience and knowledge as an Obstetrics and Gynecology physician will continue to move us in the right direction,” Friedly said then.

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Contact Mike Donahey

at 641-753-6611 or

mdonahey@timesrepublican.com