Mercy One Maternal Health Transport team added an external fetal heart monitor to the ambulance and helicopter equipment. “The cool thing is the No. 1 tool to keep the baby healthy is the mom. If you keep mom comfortable and healthy, the baby is usually the same, so you don’t really need a lot of equipment,” said Ryan Gouchel, MercyOne Emergency Transport regional director. Photo by Todd Mizener, MercyOne
Parents across Iowa have to travel increasingly farther from their homes to access maternal health care.
Forty-one birthing units closed in Iowa between 2000 and 2021. According to a report from the Center for Healthcare Quality & Payment Reform, 61% of rural Iowa hospitals no longer provide obstetrics services. Parents have to drive about 31 minutes on average to reach a hospital that does.
The March of Dimes says access to maternity health care is essential for the health of both mothers and babies, and the farther one has to drive to access that health care, the more likely they are to experience adverse maternal and infant outcomes.
One-third of Iowa counties are considered maternal health care deserts. MercyOne Medical Center established its new statewide Maternal Health Transport team in 2024 to bring families in these areas to the care they need.
“The primary utilization of the team is that there are no OB services available for them in their home community and they need to get to somewhere that has the services they require,” said Ryan Gochoel, MercyOne Emergency Transport regional director. “More often than not, this is a pre-term labor situation. It could be the baby has a known congenital heart anomaly and that patient needs to get somewhere that has a high-level NICU.”
When a call comes in, the Maternal Health Transport team will dispatch its helicopter or ground ambulance. An on-call maternal nurse will join the paramedic or flight nurse to attend the call, and they’ll bring a neonatal nurse if they believe delivery could be close. The team is in contact with a maternal fetal medicine provider back at the hospital.
The team may also help to transport a nonemergency case for mothers without access to obstetrics services in their community. The hospital also added care for postpartum mothers after they’re discharged to MercyOne’s Community Paramedicine program as a result of the maternal care transport team.
MercyOne expected to deploy the team about five times a month. In January 2025, they used it 20 times.
“What we know is that access to OB care is declining. It’s across the country. There’s just not as many providers any longer, so it’s really not a surprise to me that we had to stand up this team,” Gochoel said. “If you’re in a rural community and you don’t have OB services at your critical access facility, this is the only service available that has specialized treatment for that patient.”
Jenna and Kyle McCready, of Waterloo, pose with their twin girls, Magnolia and Stevie, in the MercyOne Des Moines Medical Center NICU. Jenna went into preterm labor at 26 weeks last year and was airlifted by the Maternal Health Transport team to MercyOne Des Moines. Photo by Todd Mizener, MercyOneMercyOne Maternal Transport team members practice transporting an infant via ambulance during a training session. “I had to train my existing clinical staff from the flight team. We had to get them a little bit of additional training in OB care, so they felt a bit more comfortable,” Gochoel said. “The more challenging component was teaching an in-hospital nurse. It’s a different world in aviation, and we have to think differently. We did some pretty extensive training over about three months to get them acclimated to the aircraft and the vernacular we speak.” Twelve nurses trained as part of the team.Photo by Todd Mizener, MercyOneMercyOne communications specialist Pat Waldorf dispatches an ambulance. MercyOne’s Maternal Health Transport team can be dispatched across the entire state. Photo by Todd Mizener, MercyOne“You’d be amazed at what the pilots pick up,” Gochoel said of the pilots that fly the team across the state. “They might pull you aside and say, ‘OK, this is what I think they got.’ And I’ll say, ‘wow, that’s pretty good for a pilot. I don’t know anything about aviation.’”Photo by Todd Mizener, MercyOneMercyOne Des Moines Medical Center nurse Sarah Steinkamp checks Magnolia McCready’s vital signs. Magnolia and her twin sister, Stevie, were delivered safely at 26 weeks after the Maternal Health Transport team brought their laboring mother from Waterloo to Des Moines.Photo by Todd Mizener, MercyOneStevie McCready sleeps quietly in the MercyOne Des Moines Medical Center NICU on Nov. 13, 2024. It would take about two hours to drive from Waterloo, where the McCreadys live, to MercyOne Medical Center. The aircraft completed the trip in less than an hour. “Waterloo has OB services, but what it doesn’t have is the level of NICU that was required for [the twins],” Gochoelsaid.Photo by Todd Mizener, MercyOne
