When she was five months pregnant, Kemerer mother Alyssa Vasey was planning her birth. When the time came, she planned to drive nearly an hour to Evanston, where her trusted obstetrician-gynecologist practices, and give birth in the hospital’s delivery ward.
But on Tuesday, a friend tagged her in a Facebook post about Evanston Hospital’s birth center closing. She was hesitant at first.
“I thought it was just gossip,” she said.
But she called her doctor’s office and the receptionist confirmed the news. Evanston Memorial Hospital also officially announced its closure on Tuesday.
Upon hearing the news, Basie, a mother of two young children, was left with few options and little direction on how to proceed. Kemmerer’s hospital closed its maternity ward two years ago. She could have given birth at home with a midwife, but she and her husband were worried about the potential for complications and the possibility that they would have to take a LifeFlight or ambulance from their remote Kemmerer home as a result. I feel anxious. Another option is to drive to Utah, where there are plenty of options, but with a due date in early March, there is a high chance of bad weather, road closures, and dangerous roads. situations may arise. Not to mention the costs associated with prenatal and childbirth travel.
“There are several options that we are discussing, and they all seem like bad options,” she said. “It’s hard to make good choices when none of the options are good.”
The closure is the latest development in a decade of urban erosion. maternity care Delivery departments in the state have been closed and hospitals are struggling to cope. Attract and maintain sufficient staff And poor care puts pregnant women and their babies at risk. travel longer distances to find services. State leaders say erosion poses an existential threat to communities because adequate health care is essential to attracting young families to rural towns. Lawmakers and medical experts have been searching for solutions, but no one answer has been found.
“It’s really complicated. There’s no silver bullet,” said Jen Simon, founder of the Wyoming Women’s Action Network. “But also, if we want to have strong communities and even a strong economy, it’s about having healthy pregnancies and knowing where people can get care and having the option to give birth in-state.” It is really a prerequisite.”
Decrease in demand
Evanston Memorial Hospital will be the fourth facility in Wyoming to close its labor and delivery department since 2014, leaving a gap in services in the southwest corner of the state. The hospital cited decreased demand in Tuesday’s announcement. Production will end on December 30th.
“This decision was difficult, but we remain committed to meeting the needs of our patients,” Cheri Willard, CEO of the hospital, said in a press release. “Over the years, we have experienced a steady decline in demand, with deliveries averaging six deliveries per month. Patients are choosing to give birth in nearby facilities, and we are responding to the evolving needs of our communities. ” https://datawrapper.dwcdn.net/j8vDy/7/
Josh Hannes, vice president of the Wyoming Hospital Association, told WyoFile in 2023 that production is important when it comes to hospital profits. In obstetrics, hospitals are staffed according to capacity, and “it costs a certain amount whether you deliver one baby a month or 1,000 babies a month,” he said. said. “Yet you still carry that burden, and that’s because of the overly complicated way health care is funded.”
OB volume is just one factor in why rural hospitals across the country are struggling. Attracting and retaining staff is also a major challenge. This is especially true when competing with urban facilities that have more resources and less demanding on-call schedules. few than half Some rural hospitals in America also offer delivery services.
Other Wyoming birth facilities that have closed in the past decade include Riverton, Kemmerer and Rawlins. Evanston’s closure will leave 17 birthing facilities in 23 counties across the state.
Eleven of the 23 districts here do not have a practicing obstetrician-gynecologist. According to the Wyoming State Department of Health. And even in some areas where there are obstetricians and gynecologists, there is only one obstetrician-gynecologist for a significant population.
The Women’s Health and Reproductive Health 2024 State Scorecard evaluates each state’s health care system based on measures such as maternal mortality, prevention, and access to health care providers. Wyoming 42nd. The state has lagged behind its neighbors.
There is growing awareness of maternal care disparities in Wyoming. Over the summer, the Joint Committee on Labor, Health and Social Services considered various factors contributing to the shortage of maternity care providers and ways to strengthen access. A subcommittee of Gov. Mark Gordon’s health task force also met last year on the topic.
However, at the end of the Labor Committee meeting, lawmakers did not draft any legislation, citing the many complexities of rural health care.
“It’s very difficult.”
The issue is complicated by everything from the high cost of malpractice insurance to the impact of abortion laws on doctors, liability concerns, and barriers for midwives to deliver in hospitals.
At the labor committee’s summer meeting on the topic, members discussed solutions ranging from tort reform to creating a gateway to midwifery through training offered by community college nursing programs. But lawmakers did not come up with a concrete solution, committee member Rep. Sarah Penn (R-Fort Washakie) said when asked about the issue in Congress. Recent Candidate Forums.
“That’s very difficult,” Penn said. “We have been particularly committed to this issue in the Labor Party. [and] Board of Health during this interim period. To be honest, we couldn’t make a decision. There are so many moving parts as to what the problem actually is that we made the decision to continue investigating this. ”
Meanwhile, Gordon’s task force is exploring possibilities such as medical fellowships for OBs, opportunities to better utilize family physicians, local OB training programs and further regionalization of obstetric care in the state.
“We’re trying to think of creative ways that we can build some capacity within the providers that we have,” said Jen Davis, director of health and human services policy for the city of Gordon.
Davis said there are some interesting initiatives underway in Laramie, including a partnership with Children’s Hospital Denver to provide specialized newborn care at Ivinson Memorial Hospital.
But she called the Evanston news “very disturbing.”
“There was already a gap in that area, and it’s going to get wider,” she said.
beyond the border
Mandy Lou, a third-generation Wyoming native who grew up in Rock Springs, began her career delivering babies in southwest Wyoming. Instead, she saw her mother’s medical options deteriorate so much that she took her skills elsewhere.
Lu gave birth to her baby in Kemmerer before the birthing facility closed in 2022. She also worked as a labor and delivery nurse at Rock Springs Hospital for 12 years, but when she became a midwife, hospital regulations did not allow her to work as a physician without a midwife qualification. Instructing doctor. Lu traveled two hours from Rock Springs to give birth at Layton Hospital in Utah. Eventually, she and her husband decided to make the move permanent and are building a home there.
She worries that a lack of training, staff and resources will increase maternal and infant mortality rates in Wyoming. These were things she wanted to offer, she said, but it was too difficult. “It’s really sad for the Wyoming community,” she said.
Evanston Regional Hospital will continue to offer women’s health services, including mammography, gynecological care and hormone therapy, the hospital said in a statement Tuesday. Additionally, the hospital said it will help labor and delivery patients transition to nearby facilities.
Kemmerer’s mother, Vassie, plans to meet with her alumnus in Evanston and receive guidance during the appointment. She knows several other expectant mothers who were planning to give birth in Evanston and wonders how the hospital could stop providing such an important service.
“They’re closing down [OB] It’s like a dermatology clinic or an infusion clinic,” she said, “but there will always be women who need to give birth.”
This article was first published wio file Republished here with permission. wio file is an independent, nonprofit news organization focused on Wyoming’s people, places and policies.
