On Friday, the Iowa Supreme Court dismissed a challenge to a law banning abortions after six weeks. The law will go into effect in about three weeks and effectively outlaw abortions in the state.
Iowa isn’t the first state to severely restrict abortion since the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, and it won’t be the last. These abortion bans endanger the lives of women. Laws like this leave women to die, unable to access miscarriage treatment, and unable to determine the outcomes of their lives.
And there is another consequence that will be equally as devastating: the closure of maternity wards, and the slow erosion of OB-GYNs from states that desperately need them.
One-third of Iowa counties are maternal care deserts, which means they have no maternity wards, no OB-GYNs and no birthing centers.
A study done by the nonprofit March of Dimes found that one-third of Iowa counties are maternal care deserts, which means they have no maternity wards, no OB-GYNs and no birthing centers.
As many as 61% of Iowa hospitals have no labor and delivery wards. And Iowa currently ranks 49th of the 50 states, second only to Arkansas, for maternal care, with 1.49 obstetricians per 10,000 women.
That same study found that 41.4% of Iowa women live in counties where they cannot access reproductive care services, and live with “very high or high vulnerability” to “adverse outcomes” such as an unexpected pregnancy, preterm birth, anxiety and depression.
Abortion care is health care. And banning abortions will further hollow out our already struggling system. I am a single mother in Iowa and I know from experience how long I have to wait to see an OB-GYN. Last year, when I was seeking care for uterine pain, it took me months to get in to see a doctor and then, when I asked about a hysterectomy, I was told by not one but two doctors that I should really not limit my options and consider that maybe a future partner might want a child. I am 41 and any pregnancy would be high risk. I already have two children whom I love and care for. With my lack of care options so limited by the state, and the reality of so few care options available, having a pregnancy in Iowa feels like taking my life in my hands.
The effect of Iowa’s regressive health care policies is already well underway. This year, MercyOne in Des Moines had to close a gynecological oncology center because it could not find a specialty physician to lead the unit. Dr. Megan Srinivas, an infectious disease physician and a Democratic state representative, told me that physicians “don’t want to practice medicine in Iowa because of our restrictive laws.” Iowa is already seeing the maternal mortality rate rise because of these maternal care deserts. And studies show that states with abortion bans have fewer OB-GYNs and midwives, and higher rates of maternal mortality.
It’s important to also remember that abortion bans and restrictions don’t affect all women equally. Ashley Garrin, a certified doula and the board vice president of the Iowa Black Doula Collective, explained in an email: “The Black maternal mortality rate nationwide is a health crises, with Black women being three times more likely to die during childbirth. In Iowa, that number more than doubles with Black women being seven times more likely to die than their White counterparts, regardless of age, income, profession or other identities. There are only a handful of Black maternal health providers in our state, which does little to overcome racial medical bias faced by many Black women, ultimately leading to their deaths or severe complications.” The outcomes for Black women and children will only worsen after the abortion ban goes into effect.
Garrin continued, “In addition to barriers to access, we will see a rise in unsafe abortion methods and individuals being subjected to a pregnancy that may not be in the best interest of their physical or mental health. Lastly, the criminalization of reproductive care will disproportionately impact Black women further. We’ve seen this play out already in other states.”
This is also happening in other states like Louisiana, where a recent study showed that abortion bans were having an impact on not just abortions, but also on the overall quality of medical care. The study’s authors write, “Louisiana’s abortion bans erode clinician’s ability to use their best medical judgment to treat patients, cause delays and denials of abortion care, postpone prenatal care, and create dual loyalty for clinicians who must navigate their duty to patients and fear of criminalization. The report’s findings also underscore how the bans disproportionately harm historically marginalized communities and groups in the state.” Gutting abortion rights means gutting health care. Banning abortions isn’t just an attack on the right to choose whether or not to have a child, it’s also an attack on those who very much want to get pregnant, such as women like Kathy Geronzin. Speaking at a rally in Cedar Rapids on the anniversary of the Dobbs decision, Geronzin, an Iowa resident, spoke about needing an abortion in 1975 after having an ectopic pregnancy. Then, Geronzin said, she was able to go to the hospital and immediately receive lifesaving care. Today, due to the closure of labor and delivery units and a lack of doctors, she’d have to drive farther to get to a hospital. Due to the slow erosion of reproductive rights in the state, “health care in Iowa was better in 1975 than it is now,” she concluded. The United States already has the highest maternal mortality rate of all developed nations. And instead of doing something to fix this and help women live, states like Iowa have used every opportunity to continue to sentence them to death — disinvesting from Medicaid, passing laws that make it difficult for qualified medical professionals to stay in the state, and banning procedures that would keep them alive. It’s exhausting to be relegated to the role of second-class citizen watching politicians bow their heads in prayer for unborn children; meanwhile, mothers who are very much alive are having their rights taken away. It’s exhausting to live in a state that I love and year after year, hear men in the Statehouse debate and rationalize how I have less of a right to privacy than a handgun owner, or a bag of trash sitting on a curb, which can’t be searched without a warrant. It’s exhausting to be relegated to the role of second-class citizen watching politicians bow their heads in prayer for unborn children; meanwhile, mothers who are very much alive are having their rights taken away. I am tired of constantly playing the role of eternal supplicant, begging for my right to live and live with dignity and respect. Making birth and motherhood more dangerous isn’t an unintended result of abortion bans. It’s exactly what they are designed to do: continue to slowly erode a woman’s right to access choice, care, autonomy and dignity, and normalize our deaths. To set up our lives and our health in opposition to the health and well-being of our children, and in the process further endanger us all.
Lyz Lenz is the author of the book "This American Ex-Wife." She lives in Iowa and writes the newsletter “Men Yell at Me.” 
