Myrtue Medical Center participates in the Iowa Perinatal Quality Care Collaborative (IPQCC)

Myrtue Medical Center’s Birthing Center is participating in a statewide initiative designed to strengthen the quality and safety of care for mothers and newborns.

The Iowa Perinatal Quality Care Collaborative (IPQCC) has worked with hospitals across Iowa on focused quality-improvement initiatives addressing maternal and newborn care. The Wellmark Foundation recently announced support for the newly launched IPQCC Engagement Program, which provides resources and coaching to participating hospitals, with a particular focus on facilities that may have fewer resources available for quality-improvement work.

“Myrtue Birthing Center has participated in the Iowa Maternal Quality Care Collaboratives since the inception in 2021 when reducing the primary cesarean rate was addressed. Myrtue Birthing Center strives to provide the best care to every mom and newborn. Working on the collaboratives enables us to fine-tune our policies and procedures on proven improvement practices which allows our patients to receive accessible and safe care,” said Michele Monson, BSN, RNC-OB, Birthing Center director at Myrtue Medical Center.

Each IPQCC initiative focuses on a specific area of maternal or neonatal care, examining protocols and procedures used by hospitals.“Each IPQCC initiative digs deeper into one specific area of maternal or neonatal care and explore the nursing protocols, standing order sets, algorithms to interpret, recognize and analyze-all necessary steps to achieve optimal care,” Monson said.

The collaborative’s first initiative in 2021 focused on the safe reduction of primary cesarean births. The goal was to reduce the rate of primary cesarean births among nulliparous, term, singleton, vertex (NTSV) births to 21.2% in Iowa by September 2022.

Myrtue’s primary cesarean rate was 4.95% during the most recent year reported by Monson.

Since the initial initiative, IPQCC has addressed several other areas of maternal and newborn care, including hypertensive crisis in obstetric patients, obstetric hemorrhage and hypoxic ischemic encephalopathy (HIE), a condition in which a newborn suffers a brain injury caused by inadequate oxygen or blood flow. The current initiative focuses on maternal mental health.

“The IPQCC initiatives look at it from a multi-disciplinary approach. Our current Maternal Mental Health project is called MOMSS, which addresses mood, mental health, substance use and social support-all impact the mental health of a new mother,” Monson said.

Myrtue Medical Center’s mental health service line works closely with the Birthing Center to provide consultations based on individual patient needs. “Myrtue Medical Center is fortunate to have a Mental Health service line. The Birthing Center works closely with our Mental Health providers to arrange inpatient or outpatient consultations based upon the needs of our patient,” Monson said.

The Birthing Center also incorporates mental health screenings into prenatal and postpartum care.“Prenatal depression and anxiety questionnaires are completed by all of our OB patients and also include another depression screening tool on day of dismissal from their labor and delivery stay. Postpartum appointments are made before leaving the Birthing Center to provide appropriate follow-up care,” Monson said.

The statewide collaborative brings together professionals with expertise in maternal and newborn care, including physicians, nurse clinicians and improvement coaches. The IPQCC team has also worked directly with Myrtue through emergency simulations, chart reviews and meetings focused on identifying opportunities to strengthen care.

“The IPQCC team consists of experienced experts in the maternal/neonatal field; professors of Obstetrics & Gynecology, Neonatology and Pediatrics, state medical director, nurse clinicians and improvement coaches all come together to improve the outcomes of mothers and newborns across Iowa.

Members of the team have been to Myrtue to provide OB emergency simulations, Shelby County EMS OB-related simulations, and chart review and Zoom meetings throughout the year to discuss and highlight areas to strengthen quality care,” Monson said.

Access to prenatal care is another component of Myrtue’s efforts to serve women throughout the surrounding area.

Myrtue OB/GYN Dr. Kelly Anderson provides an outreach clinic at Manning Regional Healthcare Center Specialty Clinic once a month and at Audubon County Memorial Hospital Specialty Clinic once a month. Jennifer Bruck, Myrtue’s board-certified women’s health nurse practitioner, also provides an outreach clinic at Manning Regional Healthcare Center once a month.

The clinics give women in the Manning and Audubon areas an option to receive prenatal care closer to home, as those communities no longer have hospitals providing obstetric delivery services.

“Myrtue Medical Center’s OB/GYN, Dr. Kelly Anderson, provides an Outreach Clinic at Manning Regional Healthcare Center Specialty Clinic once a month and at Audubon County Memorial Hospital Specialty Clinic once a month. In addition, Jennifer Bruck, Myrtue’s Women’s Health Nurse Practitioner-Board Certified, provides an Outreach Clinic at Manning Regional Healthcare Center once a month. This allows obstetric patients from the surrounding Manning or Audubon areas to access prenatal care close to home, as Manning and Audubon Hospitals no longer deliver obstetric services. Obstetric patients who seek prenatal care through either clinic come to Myrtue Birthing Center to deliver. Providing these outreach clinics helps ensure women receive highly specialized care in a convenient manner to prevent missed appointments and decrease transportation time to appointments and time away from work,” Monson said.

The Wellmark Foundation’s support of the IPQCC Engagement Program is intended to help participating hospitals strengthen facility-level quality measures, implement evidence-based practices and develop sustainable perinatal safety systems.

According to the announcement, the effort is particularly significant in Iowa, where more than one-third of counties have limited or no maternity care services, according to the March of Dimes’ 2025 report.

The statewide initiative seeks to help hospitals build systems that support safer pregnancies and deliveries while allowing families to access maternal care closer to home.