Eleven of Wyoming’s 23 counties do not have a practicing OB-GYN, the Wyoming Department of Health found, which means residents of towns from Torrington to Rawlins and Sundance must look elsewhere for prenatal and delivery care.
Roughly 16,300 women of reproductive age in Wyoming live in a county without an obstetrician, a recent fact sheet from the health department shows. And even in some of the communities with an OB-GYN, there is only a single provider for a sizable population.
Meanwhile, six of Wyoming’s 23 counties lack a delivery facility, the same assessment notes, resulting in longer drives for pregnant mothers seeking care.
The new fact sheet presents one more signal that Wyoming’s maternity care landscape is eroding, leaving families, mothers and babies at higher risk for dangerous complications related to pregnancy and childbirth.
Gov. Mark Gordon’s Health and Human Service Policy Director Jen Davis believes it’s time lawmakers consider the issue. She requested the Legislature’s Labor, Health and Social Services Committee make access to OB care an interim topic, which means the panel would study potential legislative fixes related to it.
“We have a real problem in Wyoming with lack of OB care,” she told the committee last week, adding that among other things, it impairs economic development. “It’s very hard to recruit business workforce, especially young families, if you can’t have a baby and grow your family.”
The Legislature’s Management Council hasn’t yet set interim topics, but lawmakers indicated they are concerned about the issue.
“It’s not going in the right direction in our state, certainly in the last five years,” Rep. Dan Zwonitzer (R-Cheyenne) said.
Wrong direction
Three Wyoming birthing facilities closed in the last decade — in Riverton, Kemmerer and Rawlins. That leaves 18 birthing facilities across the state’s 23 counties.
In addition, communities are losing obstetricians — doctors who are required to be on call for Wyoming hospital births in case of cesarean sections or other surgeries — due to a combination of factors. Rural OB work often comes with onerous on-call schedules, recruitment is tough and many longtime OBs are reaching retirement age.
Though some families are able to see nurse midwives, family practice doctors or other providers, the situation has prompted many families to travel elsewhere for care. But as distance from care grows, so do risks. Women and babies who live farther from delivery hospitals are more likely to experience adverse medical outcomes.
An OB Subcommittee of Gordon’s Health Task Force is working on gathering information on the issue. The health department’s recent fact sheet of maternity care access was part of that work.
The department found that just 14 Wyoming towns have practicing OB-GYNs, while eight towns have certified nurse midwives. Some towns have both and some have neither.
It also breaks down the state’s population of women of childbearing age and how many providers they have access to (excluding certified nurse midwives without a nursing license, doulas, family practice physicians and others who care for pregnant women.) In Uinta County, where 3,786 women of childbearing age reside, there is a single provider, according to the report. In Natrona County, home to 15,467 such residents, there are eight OB-GYNs.
The study also looks at the use of EMS services for OB-GYN and neonatal services — which “may indicate lack of accessible obstetric or labor and delivery care.” In 2023, there were 640 such requests. (Wyoming usually tallies more than 6,000 births a year.)
The vast majority of those requests, 95%, sought EMS transporting agencies.
This EMS reliance stood out to Davis, she told WyoFile. “I didn’t anticipate that being that high,” she said.
Eroding EMS is another critical issue in Wyoming, she noted.
“I think that only just continues to elevate that conversation of, you know, we have these collapsing systems, both OB and EMS, and two systems that are very fragile but very heavily relying on each other and why that’s problematic,” Davis said.
Adjusted for population size, 2023 EMS service requests were highest in Niobrara, Converse and Fremont Counties, according to the study.
Some 101 patients were transported to out-of-state hospitals, meanwhile; 76 by air and 26 by ground vehicle.
The issue is not isolated to Wyoming. More than half of U.S. rural hospitals no longer offer birthing services, a new study by the Center for Quality Healthcare and Payment Reform, a national policy center, found. The problem is expected to accelerate.
“Hundreds more communities are at risk of losing maternity care because of the serious financial and workforce challenges rural hospitals are facing,” the report reads. “It is not an exaggeration to say that rural maternity care is in a state of crisis, and a crisis demands immediate action.”
Getting noticed?
Though not at the center of legislation, maternity care access arose tangentially during the recent legislative session.
During a discussion on House Bill 148, which would place more regulation on abortions, Sen. Cale Case (R-Lander) argued that moving toward restricting abortions will only continue to push providers out.
In Fremont County, Case said, the health care situation has become so dire that Riverton locals organized to build a community-owned hospital. He read from a letter penned by a constituent who had to travel to another state to have her second child.
“This poor woman is in Idaho,” Case said. “A good friend of mine recently had her baby in Teton County.” Though his son was born in Lander, he said, his grandchildren may never even be born in Wyoming.
House Bill 148 passed the House and Senate and is awaiting the governor’s signature.
‘Critical’
In their pitch to lawmakers for interim work, Davis and fellow advocates laid out the situation: shuttered facilities, long distances, heavy use of emergency services.
There’s also the realities of winter travel, which comes with “additional risk to life for mother and baby in light of road closures in winter months,” a related memo read. “Interstate 80 was closed 66 times from October 1, 2022-May 31, 2023 and I-25 was closed 42 times during that same period of time.”
Executive Director of the Wyoming Medical Society Sheila Bush called the access issue “critical.” Wyoming can, however, look to other states for ideas and best practices, Bush said.
Davis told WyoFile she doesn’t see obvious catch-all solutions. “I think it’s gonna be a little bit of thinking outside of the box.”
Regardless of interim topics, the OB subcommittee under Gordon’s Task Force will continue its work. It will soon send out a survey to hospitals to help flesh out its understanding of provider numbers and access.
CORRECTION: This story has been updated to accurately reflect fact sheet information on EMS transports. -Ed.
If your town or county has a shortage of OB/GYN’s or is lacking a maternity center, thank a sanctimonious theocratic medieval intolerant Republican.
“The issue is not isolated to Wyoming. More than half of U.S. rural hospitals no longer offer birthing services, a new study by the Center for Quality Healthcare and Payment Reform, a national policy center, found. The problem is expected to accelerate.”
Absolutely true. This problem began to fester in Wyoming 2 decades ago starting with medical malpractice insurance costs, then shifted into high gear with Obama Care, and yes it is accelerating. Abortion regulations are just not the driver of the changes that will continue to affect this profession. The abortion debates probably have little affect on the changes in rural healthcare. There are numerous other issues that are driving the problems of rural healthcare.
These professionals are moving en mass to population centers and there is little the legislature can do about it.
This migration is driven by national policies that come with the bias against rural and for urban healthcare.
When it comes to rural healthcare, Wyoming politicians at all levels of legislative, executive and judicial branches are out of gas and ideas. That will continue as they simply have no control and are sidelined in the debate by forces far outside of Wyoming.
You can blame republicans, democrats, Wyoming government, federal government insurance, healthcare industries, universities, medical schools, or any number of other players you want to… but you have not yet out a finger on the policies that drive the migration of these professionals to urban settings. Until you do, you will not be able to craft solutions.
Keep talking about political rhetoric and you will never understand what the socioeconomic forces at work driving down rural healthcare access and quality.
That map from datawrapper with the pink circles probably looks very much the same as it was 10, 20, 30, 40 years ago. The number of doctors and midwives may have changed over time, but the map has not changed much over time. Shocker, Wyoming is still a neighborhood with really long driveways. The issue that 10% to 11% of women needing EMS transportation for Labor or Delivery is not really shocking in a rural setting. The maps are a distraction, access and quality are the issue.
No state needs to join the 2020s more than Wyoming. What could be such a wonderful state but run by provincial rubes.
It’ll be hard to get wyoming into the 2000’s let alone the 2020’s. Baby steps.
Getting rid of the elected folks who still want it to be the 1970’s is the first step.
First of all we live in a very lentiginous society. There are many situations, especially in medicine where things can go wrong. OB is one of the highest risks. I spent many years working for IHS in AZ, and delivered nearly a thousand babies in a hospital with every help available if it had been needed. Babies can have unexpected problems and MDs were available if needed. That would not necessarily be the case in home deliveries.
On the other hand
No OB-GYN doctor can deliver babies in a state that will throw them in jail if something happens during the delivery that the baby dies and they consider it an abortion. Since Roe v. Wade became law Republicans have always wanted to end it. It is the way they want it. The Republicans or I should say MAGA cannot govern they could care less about women and children the main thing they worry about is being able to carry a gun in the hospital not having a baby in the hospital. Politically Wyoming is a failed state. They are so anti-abortion and they vote for a rapist
This fits very neatly with the current iteration of the “Republican” party in Wyoming that has determined that women and children have no value except as aids to men. A woman or child who dies in childbirth is easily replaced just like any other asset. Wyoming has gone whacko.
Doesn’t this just fit with the frightening Katie Britt SOTU response? Keep women in the kitchen, let them give natural child birth like in the old days and ban abortion.
This was created by the ridiculous stance on abortion in this state. Driving physicians out, laws making treatment illegal and subject to loss of medical license and prison. The amount of harm from these fascist bills is getting worse everyday. To fix this the bills should be vetoed and or repealed. A member of my family had to live at Ronald McDonald house in Denver for three months to receive high risk OB care. No one to help here. The “equality” state needs to back off and leave women and their medical needs and choices alone.
No. When it comes to helping average people, our legislature will do nothing but write bills to combat wokeness and support their religion based endeavors.
Unless you are 10 ranchers needing a 8-9 figure water development, or a few thousand dollars when wildlife eats their grass, then the state instantly finds solutions.
Now that the Wyoming Womb Management Caucus is in charge of women’s healthcare the only solution to the problem will be thoughts and prayers.
Since Wyoming has adopted its laws from the Taliban, maybe a fact finding tour of how Afghanistan provides women’s healthcare will provided some insight?
Offering new OB-GYN doctors housing paid for by the State in under-served areas might be one solution. Using deed restrictions, the doctors might receive equity in the homes which in turn would entice them to remain longer.
Mr. Cole, no amount of incitements will attract ethical physicians and especially OB/Gyn doctors to a state where a bunch of old men and others that want power over women to determine what health care they can have. Especially OB specialists who’s malpractice insurance is ridiculous and are on-call around the clock. This is happening in many red states.
Seriously? You think company housing is going to compensate for the lack of integrity to perform medicine professionally rather than politically? That would just put doctors in a position where their shelter could be threatened by the legislature along with the fines, jail time, ridiculous paperwork and general persecution. Wyoming needs to take politics out of the practice of medicine. Funding hospitals would attract more doctors if the legislature would stop trying to micro manage doctor visits.