Moines

It began in the backyards of Des Moines and the living rooms of Concord and the front porches of Charleston.

I was never the likeliest candidate for this office. We didn't start with much money or many endorsements. Our campaign was not hatched in the halls of Washington. It began in the backyards of Des Moines, and the living rooms of Concord, and the front porches of Charleston. It was built by working men and women who dug into what little savings they had to give $5 and $10 and $20 to the cause.

As family farms have consolidated into megafarms run by large corporations, rural residents have moved to cities like Des Moines, the state capital, or left the state altogether.

Many hospitals don’t even have an ultrasound machine to check the status of a baby, said Mandsager, the medical director of obstetrics at Mercy Medical Center in Des Moines.