Following the closure of four Planned Parenthood clinics in Iowa, access to reproductive health care — which was strained due to an existing OBGYN shortage in the state — is becoming increasingly limited.
The closures follow the elimination of federal dollars flowing to Planned Parenthood providers nationwide who offer family planning services, sexual health screenings and treatment, gender affirming care, abortion services, and other sexual health services.
President Donald Trump froze federal funding to Planned Parenthood earlier this year, a wishlist item for conservative Republicans who disagree with providing federal funding to organizations that also provide abortion care, though federal dollars don’t pay for abortion care.
On Sept. 11, the First Circuit allowed the Trump administration to block Medicaid patients from using their insurance at Planned Parenthood health centers nationwide, effectively defunding Planned Parenthood North Central States, or PPNCS, including Iowa, among other Planned Parenthood providers.
This decision comes after Trump signed his “One Big Beautiful Bill Act” into law on July 4, which enacted a massive reconciliation package enforcing trillions in spending cuts to pay for tax cuts.
After the Trump administration announced plans to temporarily freeze and review federal funding for Planned Parenthood and its affiliates, U.S. Sen. Joni Ernst, R-Iowa, renewed her effort to pass the Protect Funding for Women’s Health Care Act.
“I am adamantly pro-life and would much rather see the dollars go to actual women’s health care,” Ernst said in an interview with The Daily Iowan on April 7.
The bill would permanently block federal tax dollars from going to Planned Parenthood or any of its related organizations or clinics.
“I am committed to defending the most vulnerable among us,” Ernst said in a March 27 news release. “That’s why I will always stand up to protect taxpayer dollars from funding any organization that takes the life of an unborn child. I’m glad the Trump administration is working to end the left’s radical abortion-on-demand agenda.”
The four locations that have closed are in Cedar Rapids, Sioux City, Urbandale, and Ames — leaving two locations available for health care resources: Iowa City and Des Moines.
According to the Iowa Rural Health Association, more than a third of Iowa’s counties are considered a maternal health desert, meaning they have no hospital or birth center offering obstetric services and no obstetric providers.
Obstetric services are a medical specialty focusing on the care of women during pregnancy, childbirth, and the postpartum period.
“Iowa Republicans continue to prioritize legislation that drives physicians away from our state,” Iowa Democrats Chair Rita Hart said in a statement to the DI. “We cannot afford to lose more providers.”
According to a news release from Planned Parenthood, these closures leave 15 health centers within the North Central States, along with virtual care that is available seven days a week and serves almost 20,000 patients a year as of May 2025.
Title X funding freeze jeopardizes care
In April, Planned Parenthood North Central States was notified of a freeze of $2.8 million in Title X funding.
According to the Planned Parenthood Action Fund webpage, Title X served roughly 2.8 million people in 2023, two-thirds of whom had incomes at or below the federal poverty level, and nearly one-third lacking health insurance.
The program was created in 1970 to provide low-or no-cost birth control and reproductive health care to low-income individuals, and was created with bipartisan support, the webpage stated.
“The program was designed to ensure quality family planning is available to everyone, regardless of their ability to pay,” the webpage said.
Title X services include birth control, cervical and breast cancer screenings, family planning education, basic infertility services, STI testing and treatment, and wellness exams.
In some cases, people who get services through the program don’t even know Title X exists, the webpage said.
The program requires health care providers to use a sliding-fee scale — a system where the cost of a product or service is based on a person’s income and household size.
RELATED: Iowa Sen. Ernst affirms support for Planned Parenthood funding freeze
Patients with income levels at or below 100 percent of the federal poverty level qualify for free reproductive health services.
The Iowa Rural Health Association said even in regions with some health care access, issues like workforce shortages, limited transportation, and a lack of specialty care can delay or block patients from receiving necessary treatment.
In a statement to The Daily Iowan, President and CEO of Planned Parenthood North Central States, Ruth Richardson, said for more than 90 years, Planned Parenthood has served as a key provider of Title X services in Iowa.
“While the federal government has currently blocked patients from using Medicaid to access our care, we will continue to serve everyone who turns to us, regardless of their insurance status, and work with patients to understand their payment options.” Richardson said. “At Planned Parenthood we continue to fight for us all.”
In 2024, Medicaid helped 27,000 PPNCS patients receive more than 300,000 birth control options, 2,500 long-acting reversible contraceptives, 70,000 STI tests, and 1,000 cervical cancer screenings, according to Planned Parenthood’s website.
Richardson said, despite ongoing attacks on reproductive rights, “our patients remain our top priority.”
Recent investments include expanding the Des Moines Health Center to double its capacity, broadening virtual care access statewide, and ensuring abortion services are available in both Des Moines and Iowa City.
Although federal restrictions currently prevent Medicaid patients from using their coverage, Planned Parenthood emphasized its commitment to serve everyone who seeks care, reaffirming “Iowans deserve accessible health care no matter their race, income, gender identity, or zip code.”
Planned Parenthood advocates of Iowa said Iowa politicians have greatly reduced access to sexual and reproductive health care, including passing a near-total abortion ban.
Planned Parenthood, nationally, will continue to “proudly provide” the full range of reproductive health care, including abortion.
“There is not now, and has never been, a plan to stop providing abortion care in the hopes of preserving federal funding. Providing abortion care everywhere it’s still legal is not up for negotiation,” Planned Parenthood said in a news release.
Under the present federal administration and Congress, the attacks are worsening.
Planned Parenthood said the attack is targeted because, among other things, Planned Parenthood advocates for sexual and reproductive rights and Planned Parenthood health centers provide abortion care where it is legal.”
In 2024, the state’s “fetal heartbeat” law does not violate the state constitution. The law bans abortion after around six weeks of pregnancy.
According to The State Court Report, the “fetal heartbeat” law addresses a 2023 law prohibiting abortion when there is a “detectable fetal heartbeat.”
According to a Planned Parenthood release, six months after the ban, the number of abortions in Iowa dropped 60 percent while Iowans traveling to Nebraska and Minnesota
increased 239 percent.
Pro-life advocates say closures are “a great thing”
Maggie DeWitte, executive director of Pulse Life Advocates, said she views the recent Planned Parenthood closures as “a great thing” and said “the state of Iowa does not need abortion clinics.”
DeWitte said women can receive quality, comprehensive medical care from the nearly 55 pregnancy resource centers located across the state.
“We don’t believe abortion is health care,” DeWitte said.
She said the pregnancy resource centers “are providing all of the same services Planned Parenthood provides without the devastating service of abortion.”
Kristi Judkins, executive director of Iowa Right to Life, said she believes the closures are the result of major political shifts reshaping reproductive health care in Iowa and nationwide.
Judkins said many pregnancy resource centers have expanded to meet women’s needs across the state.
“Those clinics are largely supported in their communities by individuals, groups, [and] companies that believe there is a support system that needs to be in place,” she said. “As pro-lifers, we have to put our money where our mouth is.”
Judkins said her personal experience with abortion shaped her perspective and the compassion she brings to her work.
“[It] was a decision made prior to my husband and I getting married,” she said. “What I didn’t know then is the one thing I know now — fetal development and understanding and appreciating the development of the unborn child within the womb.”
She said after her abortion, she experienced suicidal tendencies and depression, but through faith and post-abortion healing ministries, she came to terms and grieved the memory of the child she gave up to abortion.
Now, Judkins said her goal is to meet others with empathy.
“Hopefully [I can] explain and communicate the truth that I wished I had back then,” Judkins said.