Community Birth Collaborative

Community birth, also referred to as home or out of hospital birth, is increasing nationally and in Iowa. From 2019 to 2022, the number of community births in Iowa by CNMs increased by 66%. The primary goals of the collaborative are to (1) improve the transfer process between home and hospitals and (2) improve the safety of community birth.

Our Vision

A healthcare system where all birthing individuals—regardless of birth setting—receive high-quality, coordinated care through respectful collaboration between out-of-hospital providers and medical institutions.

Our Mission

To promote safe, equitable, and evidence-based care by developing and supporting standardized practices for out-of-hospital providers, particularly nurse midwives, in collaboration with the broader healthcare system.

Amanda Wagner, MSN, RNC-NIC

Amanda has been a neonatal nurse for 22 years, with most of her time spent at a Level II NICU. She received her MSN from the University of South Alabama and her BSN from the University of Iowa. She has been involved as an AIM team member since the first patient safety bundle under the IMQCC in 2021 and accepted a role in July 2025 as a neonatal-maternal Improvement Coach for the IPQCC.

A. Wagner headshot

Brenda Wolf, BSN, RN, C-EFM

Brenda Wolf received her Bachelor’s of Science in Nursing degree from Mount Mercy College in Cedar Rapids, IA. Brenda was always driven towards Obstetrics and that was her intentions when pursuing nursing. Upon graduation she worked on a med/surg floor for 6 months to gain experience and wait for an opening in Labor & Delivery. Brenda has 18 years of experience as an obstetric nurse in the settings of labor & delivery and mother/baby care. She has experience working in hospitals of every level from her few years as a travel nurse. She has traveled and worked in several hospitals in California and throughout Iowa. Brenda has worked in labor & delivery at Iowa Healthcare since April 2016 where she continues to serve on several unit-based committees, including OB Quality, OB Practice, CWS Retention and the AIM/IMQCC workgroup. Brenda has assisted with unit policy revision and several ongoing QI projects, including obstetric simulations. She has previously served as an OB clinical nursing instructor for Mount Mercy University. Brenda is a member of AWHONN and presented a poster at the national 2023 AWHONN convention on decreasing surgical site infections. Brenda is an AWHONN Intermediate Fetal Monitoring and Obstetric Patient Safety (OPS) instructor since 2024. Her current role consists of working 20% at the beside at Iowa Healthcare and 60% as the OB Nurse Consult for the Statewide Perinatal Care Program.

B. Wolf Headshot

Penny Smith, RN, BSN, CNS

Penny Smith is a NICU nurse and Nurse Clinician Specialist at University of Iowa Stead Family Children’s Hospital NICU. She continues to serve our state through the activities and visits of the Iowa Statewide Perinatal Care Program team. Smith serves as president of the Iowa Association of Neonatal Nurses and Co-Chairs the University of Iowa Safe Sleep Task Force. She is a published author of peer reviewed papers with her institutional partners regarding safe sleep. She facilitates learning as a lead instructor for The S.T.A.B.L.E. Program, and as a Regional Trainer for the AAP’s Neonatal Resuscitation Program. Smith has recently participated in the IHI’s Breakthrough Series in Boston to prepare for her newest role: IHI improvement coach for newborn care initiatives within the IPQCC.

Julie Lindower, MD, MPH

Julie Lindower is also a native Iowan having received her medical training at University of Iowa Carver College of Medicine after completing a BA in biology at Augustana College in Rock Island, IL. She continued at Iowa for her pediatric residency. She completed her fellowship in Neonatal-Perinatal Medicine at Cincinnati Children’s Hospital, followed by a return to Iowa where she has been a clinical neonatologist in Cedar Rapids and Iowa City. She obtained her MPH at UI College of Public Health in 2005. She has been a faculty member at the Carver College of Medicine and Iowa Healthcare’s Stead Family Children’s Hospital since 2008. She serves as Quality lead for the NICU and Site Sponsor for the national Children’s Hospitals Neonatal Consortium. Julie is the Neonatal Collaborative Director for the IPQCC.

Lindower Julie

John Dagle, MD, PhD

John Dagle studied chemistry at Creighton University in Omaha, Nebraska (1984) before earning his Doctor of Medicine and Doctor of Philosophy in Biochemistry degrees at the UI Carver College of Medicine in 1991. After graduation, he completed his Pediatrics residency (1994) and Neonatal-Perinatal Medicine fellowship (1997) at University of Iowa Health Care. 
 
John joined the faculty of Pediatrics in 1998 with additions to the Biochemistry Department in 2006 and Epidemiology in 2018. He has previously served in leadership of the Neonatal Transport Program (1998-2012) and Neonatal-Perinatal Medicine Fellowship Program (2010-2019). Currently, he is the Co-Director of the Iowa Statewide Perinatal Care Program (2019 to present) and Interim Medical Director for the NICU. 
 
His clinical interests include optimization of nutrition in the late preterm infant, understanding the synergistic roles of probiotics and breast milk in the newborn, and promoting public health initiatives to improve the outcomes of infants across Iowa.

J. Dagle

Amanda Staab, MSN, RNC-OB

Amanda completed her master’s degree through the Clinical Nurse Leader program at the University of Iowa in 2010. She has been at UnityPoint Health-St. Luke’s Hospital for the past 13 years. She has done a variety of roles in the Birth Care Center, including labor and delivery, postpartum, scrub/assist, anesthesia RN, charge, and OB educator. During COVID, she took on the challenge of the House Supervisor role. She has served on numerous unit-based, hospital-wide, and system-wide committees, simulation teams, and statewide initiatives. She serves as the AWHONN Chapter Leader for East Central Iowa and coordinates the vendors for the Iowa AWHONN Conference. She was chosen for AWHONN’s Emerging Leaders Program for 2023-2024. She currently works for the University of Iowa, under an HRSA grant, as a Clinical Nurse Improvement Coach for the Alliance for Innovation on Maternal Health (AIM) program.

Amanda Staab

Kokila Thenuwara, MD, MBBS, MME, MHCDS

Kokila is a Clinical Professor of Obstetrics Anesthesia at the University of Iowa Hospitals and Clinics. Thenuwara obtained her medical education in Sri Lanka. She completed her internship in internal medicine and her residency in anesthesiology at the University of Iowa. She obtained her master’s in medical education at the University of Iowa and her master’s in health care delivery science from Dartmouth College.

She is the Director of the New Faculty Development Program and Chair of the Best Practices Committee at the Department of Anesthesia at the University of Iowa. She is the Chair of the Simulation-Based Education subcommittee, supported by a Health Resources and Services Administration grant.

She is a written and applied examiner for the American Board of Anesthesiology, specializing in ethics and diversity, equity, and inclusion.

Kristal Graves, DNP, MSN, RN

Kristal received her ADN from Hawkeye Community College in 2000. She continued her education to obtain her master’s degree in nursing education, and in 2020 obtained her Doctor of Nursing Practice from Allen College.

She has worked in a critical access hospital for 19 years as a labor and delivery nurse. She also taught clinical, classroom, simulation, and lab for 12 years in the areas of obstetrics and pediatrics at the LPN, ADN, and BSN levels. She has been active in the areas of education and quality improvement within her career. She currently works for the University of Iowa, under the HRSA Maternal Health Innovation grant, as a Clinical Nurse Improvement Coach for the Alliance for Innovation on Maternal Health (AIM) program. Kristal is passionate about bringing quality improvement initiatives and education to Iowa’s obstetrical units. She has completed the IHI’s Improvement Coaching Program and is currently participating in the Breakthrough Series Collaborative professional development program.

Kristal Graves

Jill Henkle, RNC-OB

Jill has over 25 years of experience as a Critical Access Level 1 obstetrical nurse. She has also worked in the emergency department, medical surgical floor, telemetry, ICU, and as a travel nurse. As an OB Manager for over 10 years, Jill was successful with the implementation of maternal safety bundles, unity interdisciplinary simulation drills, process improvements, and evidence-based staff education; she still works at the bedside on a PRN basis.

Jill is an NRP Instructor, holds certification in Inpatient OB, is an AWHONN Intermediate EFM Instructor, and serves as the Iowa AWHONN Southwest Iowa Chapter Coordinator. Jill has worked with the Maternal Health Innovation grant funded by a Health Resources and Services Administration grant as an Improvement Coach through the Iowa Statewide Perinatal Care Program/AIM and is currently a member of the Iowa Mobile Statewide Simulation Team. Jill is a voice and advocate for rural maternity hospitals.

Jeana Forman, MSN, RNC-OB, C-EFM, C-FMC

Jeana is a Nursing Practice Leader at the University of Iowa Hospitals and Clinics. She has been a nurse at UIHC for over 20 years. Her career began as a staff nurse in the Inpatient OB units. She quickly found a love for staff education and has been in the area of staff education and development for the last 17 years. She is an Instructor for AWHONN Fetal Monitoring Programs, Neonatal Resuscitation, Advanced Cardiac Life Support, Advanced Life Support OB, and STABLE. She has found out firsthand how adding simulation to staff training and development improves the participant’s experience and engagement. Jeana is currently a member of the Iowa Statewide Mobile Simulation Team, which is supported by a Health Resources and Services Administration grant.

Jeana Forman

Steph Trusty, BSN, RN

Improvement Coach

Steph received her diploma in nursing from the Iowa Methodist School of Nursing and a Bachelor of Science degree in Nursing from Grand View University in Des Moines. She has worked in the obstetrical nursing field for over 40 years. Most of those years were spent working as a labor and delivery nurse and clinical educator for UnityPoint Methodist Hospital in Des Moines. For the past 15 years, she has provided leadership to the Title V Maternal Health program and Maternal Mortality Review Committee at the Iowa Department of Public Health, now Iowa Health and Human Services. She led efforts to implement the program statewide, the Period of PURPLE Crying, to prevent shaken baby syndrome. She was the team lead for the Iowa Infant Mortality CoIIN. She serves as the primary data abstractor for the Iowa Maternal Mortality Review Committee. She has provided consultation services to the Iowa Healthcare Collaborative and Iowa Medicaid on improving the quality and safety of obstetrical care in Iowa. Currently, Ms. Trusty is the AIM State Lead Coordinator. She also leads two subcommittees for the Iowa Statewide Perinatal Care Program: the statewide implementation of AWHONN’s POST-BIRTH Warning Signs and the social media campaign to encourage pregnant and postpartum women to wear a seatbelt. She has completed the IHI’s Improvement Coaching and Breakthrough Series Collaborative professional development programs.

Amanda Staab, MSN, RNC-OB

Improvement Coach

Amanda completed her master’s degree through the Clinical Nurse Leader program at the University of Iowa in 2010. She has been at UnityPoint Health-St. Luke’s Hospital for the past 13 years. She has done a variety of roles in the Birth Care Center, including labor and delivery, postpartum, scrub/assist, anesthesia RN, charge, and OB educator. During COVID, she took on the challenge of the House Supervisor role. She has served on numerous unit-based, hospital-wide, and system-wide committees, simulation teams, and statewide initiatives. She serves as the AWHONN Chapter Leader for East Central Iowa and coordinates the vendors for the Iowa AWHONN Conference. She was chosen for AWHONN’s Emerging Leaders Program for 2023-2024. She currently works for the University of Iowa, under an HRSA grant, as a Clinical Nurse Improvement Coach for the Alliance for Innovation on Maternal Health (AIM) program.

Amanda Staab

Stephanie Radke, MD, MPH, FACOG

Collaborative Director

Stephanie is a native Iowan and received her medical degree from the University of Iowa Carver College of Medicine. She then completed residency training in obstetrics and gynecology at the University of California Davis Medical Center and spent three years in community practice in Sacramento, CA. She returned to the University of Iowa to join the faculty in 2016 and is currently a Clinical Associate Professor. She is active in departmental quality improvement leadership and is a Co-Investigator on the HRSA State Maternal Health Innovation Program grant held by the Iowa Department of Health and Human Services. Through this work, she is leading efforts to form a Quality Collaborative for the state of Iowa with the goal of improving the quality, safety, and equity of maternity care in our state. She has completed the IHI’s Improvement Coaching and Breakthrough Series Collaborative professional development programs and will participate in the Improvement Advisory program in 2023.

Stephanie Radke

Kim Lake, MLS(ASCP)CM

Data Support

Kim has been involved in various aspects of healthcare for over 20 years. She is a certified Medical Laboratory Scientist who has had quality and management roles in pathology laboratories around Iowa City, most recently managing the Anatomic Pathology Laboratory at the University of Iowa Hospitals and Clinics. Throughout all her roles, she has maintained a passion for data and a firm belief in the power of data to drive informed decisions and lasting change.

Kim is currently working at the University of Iowa under the HRSA Maternal Health Innovation grant as an Epic Application Developer and Excel Wizard. Her multiple certifications in Epic applications make her an excellent resource for both general electronic medical record questions and Epic-specific information. Kim is also delighted to talk about reporting, data, and Excel with anyone and everyone.

Kristal Graves, DNP, MSN, RN

Improvement Coach

Kristal received her ADN from Hawkeye Community College in 2000. She continued her education to obtain her master’s degree in nursing education, and in 2020 obtained her Doctor of Nursing Practice from Allen College. She has worked in a critical access hospital for 19 years as a labor and delivery nurse. She also taught clinical, classroom, simulation, and lab for 12 years in the areas of obstetrics and pediatrics at the LPN, ADN, and BSN levels. She has been active in the areas of education and quality improvement within her career. She currently works for the University of Iowa, under the HRSA Maternal Health Innovation grant, as a Clinical Nurse Improvement Coach for the Alliance for Innovation on Maternal Health (AIM) program. Kristal is passionate about bringing quality improvement initiatives and education to Iowa’s obstetrical units. She has completed the IHI’s Improvement Coaching Program and is currently participating in the Breakthrough Series Collaborative professional development program.

Kristal Graves