The Henry County Health Center (HCHC) is closing its inpatient labor and delivery unit effective June 1, 2020. After that date, HCHC will continue to provide obstetrics via a “shared care” program with Great River Medical Center in West Burlington. HCHC will continue to offer the services of certified nurse-midwives to give expectant parents local access to pre- and post-natal care. The reasons for the move are financial and demographic. Over the past three years, labor and delivery services have negatively impacted the health center’s finances by $3 million dollars. Over the past 10 years, the number of deliveries has declined and market share has been lost. In addition, nearly 70% of the health center’s revenue is now provided to Medicare and Medicaid beneficiaries, and payments from these two payers do not cover the cost for providing the service.  As Iowa has expanded and privatized Medicaid, HCHC’s finances have declined. Since 2004, 26 Iowa community hospitals stopped delivering babies—with 10 of these hospitals ceasing labor and delivery services within the past two years.