You don’t have to be political to appreciate the difficulty of the choice President Joe Biden just made. Not to over-simplify, but at its core, leaving the presidential campaign was a decision about retirement.
It’s a question faced by millions of American workers each year, as we finally come to the tail end of the baby boom generation. According to a frequently quoted report from the Alliance for Lifetime Income (April 2024), we’ll see 4.1 million Americans reach 65, the traditional age of retirement, by the end of this year. Between 2024 and 2030, a record 30.4 million will achieve this milestone.
Will they all retire? Many already have, while perhaps as many as 20% will work to 70 or 74. This makes sense: Despite its symbolic meaning, we’ve known for years that 65 is no longer the default age for leaving the workforce.
People retire at their own pace and for their own reasons. Many make the choice unwillingly, due to poor health or difficulty finding suitable work. Others choose to stop working when their assets reach a certain level. And still others opt for a semi-retired lifestyle, working part-time while drawing from Social Security or retirement funds.
For those continuing to work, the decision may be financial, but for many it reflects a continuing interest in the work itself, or a need to interact with others.
Do some people hang on too long to their work lives? Undoubtedly. Conversely, some find they have retired too soon, and eventually “unretire” or start a new venture to replace what they feel is missing.
If you’re in your 50s or 60s but not yet retired, the decision is likely gaining prominence in your thinking. You already know to review your finances and talk with a planner to help calculate how much you’ll need. Here are some other steps to add to your process.
Ask yourself: What are you retiring from?
It’s important to distinguish between retiring from a job and retiring from working altogether. In the first case, you may be ready for something new or longing for fewer responsibilities, while the second option means you would be exiting the work world completely.
This distinction will impact everything from your timing to how you describe your decision to others. For example, if you want to stay in the work force, it’s strategic to call your exit a transition rather than a retirement, even if that’s what your employer is calling it.
Learn the rules
You probably already know that your age at retirement impacts your Social Security benefits, but what about withdrawals from your retirement funds, or rules concerning your pension, if you have one?
You’ll also need to confirm that you and your family will have health insurance post-retirement. If you’re planning to rely on Medicare, understanding what’s covered and when it starts will be important.
Another consideration
Also, your workplace may have standards defining under which conditions you can return in the future, should you choose to. Likewise, if you’re drawing a union pension, you may find yet another set of rules describing what work you can do once you’ve retired.
Even if your potential retirement is years away, it’s worth doing some of this research now. Having a general sense of the rules will help with your planning in the meantime.
Picture the outcome
When you imagine yourself post-retirement, what are the specifics? Having a vision of the next stage can be critical to both the decision itself and how you implement it. For example, someone who is planning self-employment might arrange for a 4-day workweek in the year before retiring, to allow time to develop the business. Likewise, a worker who plans to contract their services in their current field would benefit from internal and external networking before they leave their company.
What if your retirement vision includes relocating to another state? One idea that has worked for others: If your target date is a ways away, and if your company happens to have work in that state, perhaps you could transfer now, and enjoy your company’s support while you get re-established in your (pre-) retirement home.
Consider your current housing
Speaking of homes — if you’re expecting to change homes during retirement, consider front-loading that activity. Whether you’d be renting or owning your next place, this kind of financial transaction is usually easier when you can demonstrate income. The same goes for other large purchases, such as a car or camper.
Don’t get overwhelmed
It’s a lot to consider, but at some point the decision to retire might not be optional. Building plans early on can relieve stress, while also providing flexibility to make changes if needed.
PARIS (AP) — Sip a cool caipirinha cocktail in Brazil. Sample a spicy samosa in India. Boogie down with a DJ in France ’til the early hours. Or, do all three in a day — and perhaps meet some athletes, too.
If you’re in Paris but don’t have tickets for the Olympics, organizers want you to know that you can spend your days — and boozy nights, too — at the Parc des Nations, or Nations Park, which is hosting 15 festive national team clubhouses in what amounts to a mini-World’s Fair on the edge of Paris.
The project gives a temporary new name to Parc de la Villette, a sprawling 135-acre (55-hectare) space in the northeastern corner of the capital. It opens Saturday, once Friday’s ambitious opening ceremony on the Seine River is over, along with its enormous security demands.
Imagine one huge, multicultural fan zone. The idea is for visitors to connect with each other, with Olympic athletes (who will come for medal celebrations) and with the Games themselves, organizers said.
“The slogan of these Olympics is ‘Games Wide Open,’ and we wanted to bring that to life,” said Amelie Guignabert of Paris 2024, the Olympic organizing committee. “We really believe in it.”
All they need, she noted, is the fans — and officials are advertising in the Paris Metro and elsewhere.
Certainly, there is room for them. The biggest house is not surprisingly, Club France, where there is capacity for 5,000 to 6,000 people inside and 20,000 in the outside spaces, which include two huge fields.
Other team clubhouses are Casa Brazil, Canada Team House, Casa Colombia, Czech House, India House, Casa Mexico, Team NL (Netherlands) House, Mongolia House, Serbian House, Slovak House, Slovenian House, Chinese Taipei Pavilion, Volia Space (Ukraine) and Ekhaya South Africa.
Inside Club France is a large stage, where athletes will appear after winning medals and where nightly music events will be offered, including sets from DJs like Bob Sinclar, said Arnaud Courtier, executive director of Club France.
“We like to party,” he said.
Fans can pay 5 euros ($5.42) and stay as long as they like, watching Olympic competitions on a giant screen and athlete interviews, cheering medal winners and buying food and drink. Or, they can buy a package that could run up to 385 euros ($418) for an all-night open bar and a prime spot on the stage.
Outside are some 20 makeshift pavilions designed by architecture students that house various French sports federations. Among other activities, visitors will be able to learn from coaches and try their hand at sports.
The project started with a decision to put Club France at La Villette, said Sophie-Justine Lieber, the park’s general director. Then, countries that didn’t have clubs elsewhere decided to join in.
The park, with its many structures, was able to accommodate particular needs — for example, Slovenia and the Czech Republic wanted places with kitchens to emphasize their national cuisines, and Mongolia wanted outdoor space to erect yurts, the traditional circular dwellings.
As for beach volleyball? That’s an attraction at Brazil’s house, along with music like samba and funk. And, of course, the national cocktail, caipirinha, as well as pao de queijo, the Brazilian cheese bread.
Organizers at India’s pavilion announced it was the country’s first house at an Olympics, a step toward their dream of bringing the Games one day to India.
India House spares no effort to highlight the country’s rich culture — it has brought in a huge loom, for example, where artisans are weaving traditional saris and carpets. Among many exhibits, one wall displays Gond art from the state of Madhya Pradesh, along with photos of every Indian athlete competing this year.
A key face among them: javelin thrower Neeraj Chopra, a star in India who has 9 million Instagram followers.
There will be Indian food, of course — samosas, spiced chai tea, savory dhokla and more. Bollywood music will play, and fans will be able to try yoga and cricket.
Organizer B. Srinivasan, greeting the media Tuesday evening, declared these Games a perfect moment to introduce a new India and pointed to the many notables India has exported to the world – including political figures with Indian heritage like Rishi Sunak, the former British prime minister. And, in the most timely of references, Kamala Harris, the U.S. vice president who is now running for the top job after President Joe Biden ended his campaign for a second term.
SAN QUENTIN, Calif. — To someone living outside these dank walls, the changes might seem small.
A sergeant greets a prisoner with “good morning” rather than barking an order. Guards start calling the prisoners “residents.” They shake hands, exchange jokes.
The toilet paper locker gets replenished when its empty. The men don’t have to ask.
At California’s oldest and most infamous state prison, a monumental shift is underway through an experiment dubbed the California Model, an effort Gov. Gavin Newsom announced in March 2023 to reimagine prison life, starting at San Quentin.
San Quentin state prison, established in 1852, is the launching site for Gov. Gavin Newsom’s efforts to revamp prison culture with a greater focus on recovery and rehabilitation. (Robert Gauthier/Los Angeles Times/TNS)
The changes are modeled after prison operations in Norway and other Scandinavian countries, where incarceration is considered less a tool for punishment than an opportunity for recovery and rehabilitation.
Newsom said he envisions a prison system that doesn’t just confine lawbreakers but better prepares them for reintegrating into communities after their release. That means expanding job training and substance-use treatment, but also replacing a prison culture built on hierarchy and fear with opportunities for connection and normalized social interactions.
It will take years and hundreds of millions of dollars to fully implement the California Model at San Quentin. And whether there’s support for expanding the approach across the state’s 32 prisons hinges on what plays out at this 172-year-old institution over the next few years.
In some ways, San Quentin was the easiest place to start.
Perched on some of the most expensive real estate in California, the prison’s Marin County location affords connections with a host of progressive Bay Area research and legal aid groups eager for reform work.
The prison also encompasses the extremes of corporal punishment: Until recently, it housed the state’s death row for men, a grim unit of concrete and iron, where narrow cells are stacked five stories high. There, some of the state’s most brutal sociopaths and serial killers have lived out their days in what is effectively solitary confinement.
Outside death row, most of San Quentin’s 3,400 inmates are housed in units with medium-security ratings. That means, whether because of the nature of their crimes or their behavior in prison, they’re considered at relatively low risk of violence and allowed to gather in common areas for some portion of each day. The prison has developed an abundance of rehabilitative programs, including coding classes and a media center that’s home to an acclaimed prisoner-run podcast and newspaper.
At Newsom’s direction, the state Department of Corrections and Rehabilitation has spent the past year emptying death row, systematically transferring the roughly 630 condemned men to other prisons. San Quentin is to be reenvisioned as a full-out rehabilitation center that builds on the existing programs.
“It’s not nearly finished, but some of the most significant innovations in the corrections system in California were occurring and have been occurring at San Quentin for a long time,” said Sacramento Mayor Darrell Steinberg, a longtime Newsom ally and lead advisor of a 21-person council charged with bringing the California Model into focus.
The next major step is a projected $239 million construction project to bulldoze an old factory on the prison grounds and replace it with with airy classrooms, a fresh foods market and, one day, a prisoner-run coffee shop.
But transforming the culture will take more than bulldozers and lattes. The model relies on a dramatic shift in relations among officers and prisoners, two historically warring factions in a system built on clannish gamesmanship for survival.
And that’s proving more complex than building a cafe.
“We, the incarcerated person, are indoctrinated. The staff are as well,” said Steven Warren, a prisoner serving time on a domestic violence conviction and also a leader with San Quentin SkunkWorks, a nonprofit made up of prisoners and outside advocates focused on criminal justice reform.
Those interpersonal changes require a level of vulnerability in a culture that is wary of trust and unaccustomed to change, Warren said.
The condemned men on San Quentin’s death row are being transferred to other facilities as the state looks to refashion the prison as a rehabilitation center. (Robert Gauthier/Los Angeles Times/TNS)
San Quentin SkunkWorks hosted a guard-vs.-prisoner chess tournament at the prison, hoping to break down barriers between the historically warring factions. (Robert Gauthier/Los Angeles Times/TNS)
San Quentin SkunkWorks hosted a guard-vs.-prisoner chess tournament at the prison, hoping to break down barriers between the historically warring factions. (Robert Gauthier/Los Angeles Times/TNS)
1 of 3
The condemned men on San Quentin’s death row are being transferred to other facilities as the state looks to refashion the prison as a rehabilitation center. (Robert Gauthier/Los Angeles Times/TNS)
To break through some of the barriers, SkunkWorks coordinated a chess tournament in March between prison staff and prisoners, with checkered tables set up in a gym in the prison yard. Officers in green uniforms sat on one side, incarcerated men in their prison blues on the other.
Some players seemed skeptical, sitting in silence and studying their boards without making eye contact. Others seemed to enjoy the rivalry, trading biting barbs about their opponent’s skills.
At the far end of one row, Officer Richard Kruse claimed an easy victory over Jessie Milo after knocking his rook out with a bishop.
“He was so sure,” Kruse laughed, poking fun at Milo’s strategy. He offered friendly feedback for the next game.
“I’ve taken advice from a (corrections officer) before and ended up in the hole,” Milo said, only half joking. He was referencing a history in some prisons of guards egging on inmate violence only to throw people into solitary confinement afterward.
Kruse knocked his head back and gave a great bellow. “He’s not going to the hole today,” Kruse said.
Related Articles
Fridley teen faces upgraded murder charge in December shooting of ex-girlfriend
Man arrested in St. Paul after carjacking, shooting in Minneapolis
Jury convicts gunman for St. Paul New Year’s Eve drive-by shooting that critically injured boy, 10
Burnsville woman, 25, shot man, 70, in her father’s home, staged ‘cover-up scheme,’ murder charge says
Defendant admits scheme to bribe juror in Feeding Our Future fraud case
Milo, 44, is serving a life sentence for attempted murder, tied to a shooting he committed in his 20s. He’s developed an interest in art at San Quentin and serves as a mentor to younger men coming in. For the chess tournament, he designed a “California Model” poster to hang in the gym, painted half in blue for the imprisoned, half in green for the guards.
Milo wants to see the California Model succeed: “We can’t keep fighting each other expecting a different outcome,” he said. But he can’t help but have doubts.
Along with chess matches, San Quentin is hosting kickball tournaments and flag football games as a way to foster more collegial relations. But prisoners are still locked down for several hours a day in cramped cells — two men sharing dingy 5-by-11 foot quarters crammed with bunk beds, a toilet and a sink — without access to programming or family visits, Milo said.
Other than Kruse and a handful of other officers, Milo said, most prison staff are at best resistant, more often hostile, toward the changes.
“They feel the incarcerated people are being coddled,” Milo said. “The California Model is not really a grand gesture. The California Model is just kindness, courtesy and normalcy.”
Kruse, 31, with an easy manner and boyish grin, is one of the few openly enthusiastic supporters of the California Model.
His mom worked in administration at San Quentin, so Kruse has lived on the prison grounds since he was a kid. He joined the guard ranks at 21 and says he loves his job so much, it would take something “catastrophic” to leave — like “an earthquake shifting San Quentin into the sea.”
The work feels personal. In 2013, his mom had a heart attack on the job. She survived because a prisoner performed CPR long enough to stabilize her before paramedics arrived. Her survival is something he keeps in mind as he walks the yard — and before he decides to write someone up for a rules violation.
“I’ve always been a big believer that a lot of the way we go about treating at least most of these guys is kind of unnecessary,” Kruse said. “So when (the California Model) became an official policy, I was stoked.”
Kruse was placed on a “resource team” to help with the cultural shift, one of a small group of officers who help set up events such as the chess match and work with condemned men preparing to transfer out of death row.
Multiple times a week, Kruse engages death row prisoners, first conversing through the bars, then inviting someone to join him in an old prison hospital room re-purposed for social interaction. The room is decorated in a kaleidoscope of murals painted by condemned men, and stocked with board games.
An avid gamer, Kruse brought in his Nintendo Switch and spent some of his own money to fill the shelves with games like Uno, Just One and Tsuro. His hope is to use the games — and the interaction around friendly competition — to model “pro-social behavior” for men preparing to transfer to other prisons.
As part of the death row dispersal, many of the condemned men will be able to mix with the general prison population at their new facility. For most, it will mark an unsettling shift after decades of near-total isolation at San Quentin.
On a recent June day, Kruse sat in the room with Wayne Adam Ford, a convicted serial killer who in 1998 turned himself in at the Humboldt County Sheriff’s Office carrying a woman’s severed breast in a plastic bag. Ford said the sessions have helped him reacclimate to other humans after years of living in the darkness of his mind.
“I wasn’t sane then. I’m not sure I’m all that sane now,” he said. “But I’m saner than I was.”
The interactions can be uncomfortable, Kruse said. But he considers the lessons in socialization worth it — both for the guys who will never get out of San Quentin and especially for the many men who eventually will.
“There’s a lot of people at San Quentin that have either already halfway turned their lives around, or are trying to get that push to turn their lives around,” Kruse said. “They’re gonna leave someday. … That’s going to be your neighbor, might be your family member’s neighbor. Those guys, if I can work with [them] to make [them] better, that, to me, is what it’s about.”
San Quentin SkunkWorks hosted a guard-vs.-prisoner chess tournament at the prison. (Robert Gauthier/Los Angeles Times/TNS)
“There’s a lot of people at San Quentin that have either already halfway turned their lives around, or are trying to get that push to turn their lives around,” says Officer Richard Kruse. (Robert Gauthier/Los Angeles Times/TNS)
San Quentin is hosting chess matches, kickball tournaments and flag football games as a way to foster relationships and more normalized social interactions in prison life. (Robert Gauthier/Los Angeles Times/TNS)
1 of 3
San Quentin SkunkWorks hosted a guard-vs.-prisoner chess tournament at the prison. (Robert Gauthier/Los Angeles Times/TNS)
Still, Kruse concedes he’s an anomaly. He estimates he’s among 5% of staff who consider themselves avid supporters of Newsom’s vision. But it’s a start. “As far as it comes to getting staff on board, I think every institution has at least a few people who are willing to give this a genuine shot,” he said. “And from there … it’s like pebbles down a mountain.”
Tiffanie Thomas, legislative relations representative for the California Correctional Peace Officers Assn., the union representing 27,000 corrections workers, takes a more skeptical view.
While Thomas is generally supportive of the California Model — and any reforms that would make prison work less stressful — she said many officers worry that the push for a more “Shangri-La, fa-la-la” environment poses a safety threat. Officers spend their shifts with their heads on a swivel, she said, ever on guard in case a fight breaks out or they’re attacked. After all, it’s “still prison.”
“Nobody is focusing on the fact that if something happens, we still have to be trained to do certain things,” Thomas said. “Just because we’re calling something pretty doesn’t make it actually pretty.”
Adding to the challenges: Even after a decade of legislative efforts to ease sentencing laws, California remains a state of mass incarceration.
The state’s prison population is vastly larger and more complex than the prison system in Norway that the California Model draws on for inspiration. While Norway’s longest prison term is typically two decades, more than 30,000 people are serving life sentences in California.
Steinberg, the advisory council chair, acknowledged the major differences, noting, “We’ve never said that we’re just going to take the Norway Model and put it on top of California and boom, that’s the change.”
Still, he said, the idea that California should be doing more to prepare people for life outside prison — giving them the social skills and training they need to thrive once they’re released — seems not only humane but a wise investment given the costs of incarceration.
“I really am a big believer that the way you make systemic change is to plant a big seed,” Steinberg said, adding that it also requires patience. “It’s going to take — I don’t know how long — hopefully less than a generation.”
Miguel Sifuentes is among those who want to believe the changes underway will be meaningful.
Sifuentes, 45, is serving a life sentence for first-degree murder, stemming from his role in the 1998 shooting death of a sheriff’s deputy in Alameda County. During his decades behind bars, he’s tried to improve himself through classes and self-help programs.
Sifuentes took part in a basketball game between prisoners and guards in November that was covered by a local TV station. During an interview after the game, Sifuentes called out to one of the guards, who ran over and embraced him in a warm, unscripted hug. Sifuentes, overcome with emotion, sobbed on the officer’s shoulder.
Hugging the officer was a “restorative moment,” Sifuentes later told The Times, “a small amend to the law enforcement community” he harmed 26 years ago.
For Sifuentes, who has twice been denied parole, the notion of a kinder, gentler San Quentin has appeal. It is for now — and maybe forever — his home.
But the more contentious changes, he said, lie ahead. There’s such a “narrow way out of this place,” Sifuentes said. What will it take for the state to recognize his remorse and rehabilitation? And for the public — even the guard who embraced him — to welcome him home as their neighbor?
“Is California,” he asked, “willing to have the harder conversations about who we are going to let out?”
OSKALOOSA, Iowa — Rural regions like the one surrounding this southern Iowa town used to have a lot more babies, and many more places to give birth to them.
At least 41 Iowa hospitals have shuttered their labor and delivery units since 2000. Those facilities, representing about a third of all Iowa hospitals, are located mostly in rural areas where birth numbers have plummeted. In some Iowa counties, annual numbers of births have fallen by three-quarters since the height of the baby boom in the 1950s and ’60s, when many rural hospitals were built or expanded, state and federal records show.
Similar trends are playing out nationwide, as hospitals struggle to maintain staff and facilities to safely handle dwindling numbers of births. More than half of rural U.S. hospitals now lack the service.
“People just aren’t having as many kids,” said Addie Comegys, who lives in southern Iowa and has regularly traveled 45 minutes each way for prenatal checkups at Oskaloosa’s hospital this summer. Her mother had six children, starting in the 1980s, when big families didn’t seem so rare.
“Now, if you have three kids, people are like, ‘Oh my gosh, are you ever going to stop?’” said Comegys, 29, who is expecting her second child in late August.
These days, many Americans choose to have small families or no children at all. Modern birth control methods help make such decisions stick. The trend is amplified in small towns when young adults move away, taking any childbearing potential with them.
Hospital leaders who close obstetrics units often cite declining birth numbers, along with staffing challenges and financial losses. The closures can be a particular challenge for pregnant women who lack the reliable transportation and flexible schedules needed to travel long distances for prenatal care and birthing services.
The baby boom peaked in 1957, when about 4.3 million children were born in the United States. The annual number of births dropped below 3.7 million by 2022, even though the overall U.S. population nearly doubled over that same period.
West Virginia has seen the steepest decline in births, a 62% drop in those 65 years, according to federal data. Iowa’s births dropped 43% over that period. Of the state’s 99 counties, just four — all urban or suburban — recorded more births.
Births have increased in only 13 states since 1957. Most of them, such as Arizona, California, Florida, and Nevada, are places that have attracted waves of newcomers from other states and countries. But even those states have had obstetrics units close in rural areas.
In Iowa, Oskaloosa’s hospital has bucked the trend and kept its labor and delivery unit open, partly by pulling in patients from 14 other counties. Last year, the hospital even managed the rare feat of recruiting two obstetrician-gynecologists to expand its services.
The publicly owned hospital, called Mahaska Health, expects to deliver 250 babies this year, up from about 160 in previous years, CEO Kevin DeRonde said.
“It’s an essential service, and we needed to keep it going and grow it,” DeRonde said.
Many of the U.S. hospitals that are now dropping obstetrics units were built or expanded in the mid-1900s, when America went on a rural-hospital building spree, thanks to federal funding from the Hill-Burton Act.
“It was an amazing program,” said Brock Slabach, chief operations officer for the National Rural Health Association. “Basically, if you were a county that wanted a hospital, they gave you the money.”
Slabach said that in addition to declining birth numbers, obstetrics units are experiencing a drop in occupancy because most patients go home after a night or two. In the past, patients typically spent several days in the hospital after giving birth.
Dwindling caseloads can raise safety concerns for obstetrics units.
State health department confirms three more measles cases in metro, including Ramsey County
A study published in JAMA in 2023 found that women were more likely to suffer serious complications if they gave birth in rural hospitals that handled 110 or fewer births a year. The authors said they didn’t support closing low-volume units, because that could lead more women to have complications related to traveling for care. Instead, they recommended improving training and coordination among rural health providers.
Stephanie Radke, a University of Iowa obstetrics and gynecology professor who studies access to birthing services, said it is almost inevitable that when rural birth numbers plunge, some obstetrics units will close. “We talk about that as a bad event, but we don’t really talk about why it happens,” she said.
Radke said maintaining a set number of obstetrics units is less important than ensuring good care for pregnant women and their babies. It’s difficult to maintain quality of care when the staff doesn’t consistently practice deliveries, she said, but it is hard to define that line. “What is realistic?” she said. “I don’t think a unit should be open that only delivers 50 babies a year.”
In some cases, she said, hospitals near each other have consolidated obstetrics units, pooling their resources into one program that has enough staffers and handles sufficient cases. “You’re not always really creating a care desert when that happens,” she said.
The decline in births has accelerated in many areas in recent years. Kenneth Johnson, a sociology professor and demographer at the University of New Hampshire, said it is understandable that many rural hospitals have closed obstetrics units. “I’m actually surprised some of them have lasted as long as they have,” he said.
Johnson said rural areas that have seen the steepest population declines tend to be far from cities and lack recreational attractions, such as mountains or large bodies of water. Some have avoided population losses by attracting immigrant workers, who tend to have larger families in the first generation or two after they move to the U.S., he said.
Katy Kozhimannil, a University of Minnesota health policy professor who studies rural issues, said declining birth numbers and obstetric unit closures can create a vicious cycle. Fewer babies being born in a region can lead a birthing unit to shutter. Then the loss of such a unit can discourage young people from moving to the area, driving birth numbers even lower.
In many regions, people with private insurance, flexible schedules, and reliable transportation choose to travel to larger hospitals for their prenatal care and to give birth, Kozhimannil said. That leaves rural hospitals with a larger proportion of patients on Medicaid, a public program that pays about half what private insurance pays for the same services, she said.
Obstetrician Taylar Swartz visits with patient Addie Comegys and her husband, Jeff Comegys, who had traveled 45 minutes to the Mahaska Health hospital in Oskaloosa, Iowa, for a prenatal checkup. Addie Comegys was seven months pregnant and soon would need to make the trip weekly for checkups at the hospital, which is bucking a national trend by maintaining labor and delivery services. (Tony Leys/KFF Health News/TNS)
Obstetrician and gynecologist Taylar Swartz uses an ultrasound scanner to check the health of Addie Comegys’ baby on May 30, 2024. Comegys, who was seven months pregnant, had traveled 45 minutes for her prenatal appointment at Mahaska Health in Oskaloosa, one of a few rural hospitals in Iowa still offering labor and delivery services. (Tony Leys/KFF Health News/TNS)
1 of 2
Obstetrician Taylar Swartz visits with patient Addie Comegys and her husband, Jeff Comegys, who had traveled 45 minutes to the Mahaska Health hospital in Oskaloosa, Iowa, for a prenatal checkup. Addie Comegys was seven months pregnant and soon would need to make the trip weekly for checkups at the hospital, which is bucking a national trend by maintaining labor and delivery services. (Tony Leys/KFF Health News/TNS)
Iowa ranks near the bottom of all states for obstetrician-gynecologists per capita. But Oskaloosa’s hospital hit the jackpot last year, when it recruited Taylar Swartz and Garth Summers, a married couple who both recently finished their obstetrics training. Swartz grew up in the area, and she wanted to return to serve women there.
She hopes the number of obstetrics units will level off after the wave of closures. “It’s not even just for delivery, but we need access just to women’s health care in general,” she said. “I would love to see women’s health care be at the forefront of our government’s mind.”
Swartz noted that the state has only one obstetrics training program, which is at the University of Iowa. She said she and her husband plan to help spark interest in rural obstetrics by hosting University of Iowa residency rotations at the Oskaloosa hospital.
Comegys, a patient of Swartz’s, could have chosen a hospital birthing center closer to her home, but she wasn’t confident in its quality. Other hospitals in her region had shuttered their obstetrics units. She is grateful to have a flexible job, a reliable car, and a supportive family, so she can travel to Oskaloosa for checkups and to give birth there. She knows many other women are not so lucky, and she worries other obstetrics units are at risk.
“It’s sad, but I could see more closing,” she said.
(KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs of KFF — the independent source for health policy research, polling and journalism.)
