Wyoming has a growing maternity care shortage, and WyoFile’s Katie Klingsporn has taken the time to dig into the causes and impacts of the lack of resources for expecting mothers in the state. Her investigative work is being released throughout December every Wednesday. The first article told the stories of many families who have upended their lives to find care.
Wyoming Public Radio’s Kamila Kudelska asked Klingsporn to share one of those stories.
This interview was edited lightly for brevity and clarity.
Katie Klingsporn: First, I will say that they were all sort of harrowing. I think it just goes to show that having a baby is a really big deal. Even in cases when it goes “smooth.”
Maybe an exemplary story would be the woman Bailey. She had a lot of complications in her first pregnancy. In her first labor, she ended up getting life flighted. And her daughter was born via C-section five weeks early. When she got pregnant again, and she started looking around for options knowing that she was high risk, she didn't feel comfortable with what Fremont County [had] to offer her. She decided to go to Salt Lake City and have her baby.
She ended up having a VBAC, which is a vaginal birth after cesarean. And you can't do it in most Wyoming hospitals. They just don't allow it because of the risk for rupture. It was really telling of a lot of our shortages.
Kamila Kudelska: Regarding those shortages, you focus on Fremont County. Can you talk about how, maybe even five years ago, there didn't seem to be a problem? And how has that changed?
Klingsporn: Fremont County is not unique in this. It's kind of this bad coincidence – these factors converging all at once. One doctor told me, you know, she believes a big part of it is that there are a lot of OBGYNs who are sort of in the same age group. And they're all hitting retirement age. So a lot of people are leaving.
But in 2021 or 2020, there was an independent practice at the clinic. There were two OBs and two midwives. Then there was a private practice with an OB in the hospital here [in Lander]. The OB has to be on call at all times, even if the midwife is delivering the baby, in case the need for a Cesarean section or [if] surgery comes up. So that's why the OB is such a crucial part of the puzzle. They always need to be available.
And then things just happened. One of the OBs had a medical issue and he ended up leaving. And one of the midwives decided to pursue something else. And all of a sudden it was down to two…an OB and nurse midwife. And that OB who's in my second story, he just got really burned out. He's been doing it for a really long time. The call schedule is very onerous when you're sharing it with one other person. I think it was an agonizing decision, but he walked away. So there is one OB here. He has a midwife also.
If a woman goes into labor, she will be able to deliver her baby at SageWest hospital in Lander. But there is a greater chance that she will deliver with locums, which is a traveling doctor. And for pregnant women, the idea of delivering with a doctor who you've never met or never seen before can cause a lot of anxiety. And it's just not something they want to do.
Kudelska: It's like a revolving door. Someone retires. That puts a burden on someone else, and then they feel like they can't do it anymore. And it's putting a burden on the rest of the facilities in the state that exist. So, I wonder if you can talk a little bit about how – there only being one OB in Fremont County – how that's putting more pressure on other communities in the state.
Klingsporn: A lot of Fremont County women are choosing to go to Hot Springs Health in Thermopolis. Their demand is growing because of that. But when I talked to the Lander doctor, he said it used to be that people would come here from elsewhere. And now it feels like it's reversed. So there are also quite a few patients who go to Jackson, and Jackson is having its own version of the crunch. Unfortunately, several providers there have recently stepped away as well. I think one OBGYN told me that five providers in recent years have either closed or or moved out.
Kudelska: I know that you still have a couple more parts of the series that come out and that they might look at some solutions. Can you talk a little bit about that?
Klingsporn: It's a really tricky situation and everybody agrees that it is hard and it's not good. There's community leaders who say we have to have a hospital and a birthing facility in order to build a strong community for our economic future. Out of the ideas that people have thrown around, one concrete solution is what has been happening in Riverton. Some residents got together and created a medical district and they are building a community-owned hospital in Riverton. And part of that is in response to the services that were closed at the Riverton SageWest campus. One of those services is OB.
Another solution I think can be found on the reservation at Wind River Cares and IHS (Indian Health Services), where they're just concentrating a lot of energy and resources into building out their OB team and as well as other support services. For example, they have really robust transportation assistance for their patients if they have to be referred to a specialist elsewhere. And they have nurses who are basically assigned a family. So when the women become pregnant, they feel like they have a team tracking them and looking out for them.
