Wyoming lawmakers are looking into maternity health care issues.
The Joint Labor, Health and Social Services Committee took on this issue as an interim topic. Testimony from health and state officials paint a picture of decreasing deliveries, difficulty recruiting and retaining OB-GYNs, and closures of labor and delivery units in the state.
Since 2018, three labor and delivery units have closed across the state. Two cited financial costs of staffing the department after births continually decreased.
Jenn Davis, Gov. Mark Gordon’s health and human services advisor, said part of the problem for hospitals and OB-GYNs stems from the very nature of Wyoming: a rural state with a small population.
“They just don’t have enough to justify the service line in their budget and also don't have enough volume to keep current in their skill and make sure they are competent in doing those deliveries," she told the committee.
Davis was presenting the results of a survey of Wyoming hospitals administered by the Governor’s Health Task Force OB Subcommittee. It was meant to get a better picture of what’s happening with maternal care across the state. Fifteen hospitals responded, including the single birthing center in the state. When asked what the main obstacles are for providing labor and delivery services, the majority of hospitals said the inability to employ trained or skilled staff to offer the services. Other top reasons included the inability to hire OB-GYN physicians, affordability of service for the hospital, and insurance and liability of service.
Davis and the Wyoming Department of Health (WDH) remarked another huge obstacle to keeping this type of care in communities is how few babies are born in the state.
“Based on the low volume [of births], people can’t keep their skills up to be competent in doing deliveries,” said Davis. “We don’t have a high level NICU here, so high risk [births] already goes out of the state. So this is just looking at how we can do better for our low risk births in Wyoming.”
WDH officials said labor and delivery units require significant nursing staff, having sufficient physicians or locum tenens (temporary physicians) on call. Those are usually fixed costs, regardless of volume of births. According to the Wyoming hospital delivery trends graph by the WDH, all counties' number of births are either plateauing or decreasing, except for Hot Springs County.
“There’s fewer women of childbearing age in our state having babies,” said Franz Fuchs, WDH chief policy analyst. “I’m not sure volume is 100 percent the reason for things. A lot of it has to do with revenue and management of the hospital and decisions that were made by the hospital.”
Fuchs pointed out that Lander may have cause for concern, as the number of births recently dropped significantly.
Davis ultimately compared the issue to one reason why the state is unable to keep younger people in the state.
“We’re not going to be keeping our young people here in the state or bringing young people in the state if they can’t have babies,” she said.
Besides the low volume of births and a nursing shortage in the state, some officials testifying mentioned Wyoming’s recently enacted abortion bans, which are currently paused due to legal challenges. Eric Boley, president of the Wyoming Hospital Association, said that uncertainty is a problem in recruiting physicians.
“When they find out where we are right now, they're concerned and we are not able to recruit,” said Boley. “They want to go to other places because there is ambiguity and there is concern with existing law.”
Boley said the stance of lawmakers to make abortion illegal in the state is well known. He said a solution could be to rewrite the law so that physicians aren’t penalized or criminalized for performing an abortion, or making it more clear when a physician would be criminalized for performing an abortion.
The committee ended the discussion saying they will look into potential solutions. Those included creating some kind of program for family doctors to get training in OB-GYN skills and sending OB-GYNs to neighboring states for a week at a time to stay up to date with more complicated procedures like cesarean sections. Lawmakers also may consider looking at creating some sort of agreement between certified midwives and OB-GYNS to work together.
The committee will meet again in June.
