In push to lower pregnancy death rates, Iowa joins national initiative

Program initiative aims to safely lower C-section rates

A doctor measures the pregnant belly of a patient at Wayne County Hospital in Corydon on Thursday, Sept. 26, 2019. (File
A doctor measures the pregnant belly of a patient at Wayne County Hospital in Corydon on Thursday, Sept. 26, 2019. (File photo/The Gazette)

In its ongoing efforts to improve maternal mortality rates across Iowa, the state public health agency said Monday it has joined a national collaborative to implement best practices regarding labor and delivery in Iowa’s hospitals.

The Iowa Department of Public Health announced the agency has enrolled in the Alliance for Innovation on Maternal Health, or AIM program, which is a national multidisciplinary collaborative meant to share best practices for maternal care.

The program, which is housed at the American College of Obstetricians and Gynecologists, helps hospitals reduce complications and deaths in those who are pregnant or have recently given birth through education, peer-to-peer learning and other “data-driven, evidence-based care practices.”

“A lot of other states have used (the AIM program) to drive quality improvement on statewide basis. They have resources to help us, so we want to take advantage of that and learn from other experts,” said Stephanie Trusty, a nurse clinician with IDPH’s Bureau of Family Health.

Enrollment in the AIM program is part of the state’s ongoing Maternal Health Innovation Grant, a $10 million, five-year federal grant to the state that was announced last year. In partnership with the University of Iowa Health Care, the state agency will use grant funding to address root causes of maternal mortality — or pregnancy-related deaths.

“More than half of Iowa’s maternal deaths are preventable, and we believe that we can save lives here in Iowa with the AIM program,” Dr. Nalo Johnson, director of IDPH’s Division of Health Promotion and Chronic Disease Prevention, said in a news release.

AIM program initiatives will be led by a statewide work group called the Iowa Maternal Quality Care Collaborative.


All hospitals across the state are invited to be part of the initiative. Trusty said state public health officials hope to officially launch the effort in January, after IDPH has built a statewide database for participating hospitals to share and track metrics with the state agency.

For the next two years, Trusty said state public health officials plan to help hospitals safely reduce the number of primary caesarean births, which refers to women how deliver via a cesarean section, or C-section, for the first time.

The Iowa Maternal Quality Care Collaborative identified this as the first initiative after a recent report from another state maternal quality care work group identified hemorrhaging as one of the leading causes of pregnancy-related deaths in Iowa.

The report — published in March by Iowa’s Maternal Mortality Review Committee — found that a morbidly adherent placenta, which occurs when the placenta fails to detach from the uterus, increases the risk of blood loss for women.

While it’s still a rare occurrence, Trusty said repeat C-sections increases the likelihood of a morbidly adherent placenta.

“We do want to acknowledge C-sections can be lifesaving, but there’s been a rapid increase in caesarean birthrates over the past 40 years,” Trusty said. “…. That’s occurred without clear evidence around maternal and neonatal mortality or morbidity. We’re doing more, but we’re not always getting the results we should.”

More information on the AIM program can be found on its website,

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