Maternity care deserts pushing Wyoming women to Utah for labor and delivery

KEY TAKEAWAYS

Maternity care deserts in Wyoming can push women to Utah for childbirth services.
Hospital closures and financial struggles worsen access to labor and delivery care.
Proposed solutions include workforce expansion, mobile health care and Medicaid expansion discussions.

KEMMERER, Wyo. — Maternity care deserts across Wyoming are growing as hospitals close labor and delivery units for financial reasons.

That vanishing access is forcing many women to drive hours to deliver their babies.

Kemmerer mom Alyssa Vasey had visions of soft snuggles and sweet sibling introductions when she was pregnant with her third child.

Halfway through her pregnancy, she found out from a Facebook post that her plan to deliver at Evanston Regional Hospital was no longer possible.

"I just called the office and I'm like, 'I just saw this on Facebook, that's not true, is it?' And the receptionist was like, 'Unfortunately, we just found out a few minutes ago,'" Vasey said.

That hospital discontinued labor and delivery services in December, citing a decline in demand over the years. In a press release, the CEO said the hospital averaged six deliveries each month.

It was déjà vu for Vasey. Her hometown hospital, South Lincoln Medical Center, closed its labor and delivery unit while she was pregnant with her second.

"I cried for like three days because I was just so sad," Vasey said. "I love my OB."

Vasey and her husband interviewed midwives, but decided it wasn't the best choice for them.

"What happens if something goes wrong? I go to this little tiny rural hospital that's not equipped to have babies or anything with women's care, really, and I'm supposed to be (flown by helicopter) two hours to Salt Lake? That's not for me," she said.

Vasey said she also wanted to have the option of pain medication available.

"They can't give you epidurals or any sort of narcotic pain relief, anything like that," she said. "I didn't necessarily want that, but if I needed it, I wanted it to be an option."

They also looked into Utah hospitals, but worried about the drive. Vasey's baby was due in March, when dangerous, wintry conditions weren't out of the question.

"Even if I made it there, contractions hurt. That's not really safe to be driving yourself two hours," she said.

A road trip to a routine appointment that went wrong helped Vasey decide what to do.

"My dad and I were traveling on I-80 through the Green River tunnels, and on our way back, there was a big accident and the tunnels started exploding," she said.

Not wanting to risk laboring on the interstate, she opted to be induced.

"It just became very real that there could be delays," Vasey said.

She learned her doctor at Evanston Regional Hospital started working at Memorial Hospital of Sweetwater County in Rock Springs, an 80-minute drive from Kemmerer. That's where she delivered her son.

"I really would not like to go through all this again, it was just too much," Vasey said.

She said her son, Ian James, will likely be her last because of what she and other Wyoming women are going through.

"Other women have talked about renting Airbnbs in Utah so they're close," Vasey said. "My other friend, she had her baby in the ambulance trying to get to Rock Springs."

Labor and delivery closures

Memorial Hospital of Carbon County in Rawlins is another facility that closed its labor and delivery unit.

"We've seen four birthing facilities closing in the last dozen years," said Honour Hill, March of Dimes director of maternal and infant health initiatives. "We know that many counties, about 11, are lacking a practicing OB-GYN."

March of Dimes calls these maternity care deserts. The lack of health care accessibility is pushing women to travel to OB-GYNs, especially in Utah.

"I think what we might end up seeing is maybe expectant mothers that are ... flown in, or we might see babies that are born in the back of ambulances," said Eric Boley, president of the Wyoming Hospital Association.

Declining birth rates, struggles for hospitals

"There's not a lot of money made because a majority of the babies in our state are born on Medicaid," he said. "They're high fixed overhead costs."

Boley said it takes a lot of staff and resources to deliver babies safely, including highly trained nurses and doctors, anesthesiologists, and respiratory therapists.

He said the state has declining birth rates.

"If you're only delivering 20 or 30 babies a year, but you have that overhead that's always in place and keeping the training and everything, it becomes really problematic and difficult," Boley said. "When the majority of your deliveries are Medicaid babies with mothers, it makes the financial reality pretty difficult."

He said many Wyoming hospitals are struggling financially.

"There are 30 hospitals in the state, most of them are independent and small," Boley said. "With the pandemic, we've seen that situation exacerbated for a myriad of different reasons. But, they're all trying to find a way through."

He said the state's abortion laws have made recruitment and retention of doctors and nurses more difficult.

"There are restrictions on the types of medication that providers can use to save a mother that might also be used to induce an abortion," Boley said. "There's a lot of concern about the fact that they could be found guilty of violating that new law."

Boley said many medical providers retired early after the pandemic. He said Wyoming also has an aging population, so many of them are reaching retirement age.

Proposed solutions

"We really need to come up with a good plan in our state," Boley said. "That's the honest truth. And we need to be able to protect expectant mothers and their unborn babies. We've got collaboration with some of our larger facilities working with those areas that have closed their OB services … that still doesn't answer the delivery problem. So I'm glad that it's a priority for our governor's health care task force for the legislature."

He said Wyoming leaders are looking at what other states are doing for solutions.

March of Dimes proposed four solutions: Increase the workforce, access to centers, mobile health care, and value-based reimbursement rates and models.

"We very much encourage midwifery care," Hill said.

Read the entire story at KSLTV.com.

The Key Takeaways for this article were generated with the assistance of large language models and reviewed by our editorial team. The article, itself, is solely human-written.