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Editorial board: Obstetric service cuts represent real concern for Wyoming communities

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Pregnancy

A doctor performs an ultrasound scan on a pregnant woman at a hospital in Chicago in 2018. Two of Wyoming's hospitals are cutting their labor-and-delivery services.

Imagine going into labor on a snowy night in December. The wind is howling, making travel difficult to impossible. It’s freezing and icy.

Now imagine the closest labor-and-delivery unit isn’t down the street, or even a short drive across town. Instead, it’s 90 or 100 miles down a highway that’s slick with blowing snow.

That scenario is a hypothetical today. But it could soon play out in a growing number of Wyoming communities. This spring, hospitals in Rawlins and Kemmerer announced they were cutting their obstetric services. When they do, seven of Wyoming’s 27 acute-care hospitals will lack labor and delivery services.

There are multiple reasons for the loss of these critical services. Staffing shortages are a main driver. Some hospitals rely on traveling nurses to supplement their own staffing, but those nurses have grown in demand since the pandemic began. That means there is more competition for them, which translates to higher costs. Burnout has been cited as another reason. Many nurses are worn out after a grueling two years. Finally, training is an issue. Getting providers the experience they need to flourish has been a challenge.

The result? It’s getting “harder and harder,” as the head of the Wyoming Hospital Association said recently, for hospitals in our state to provide obstetric services.

In the case of both Kemmerer and Rawlins, other hospitals are stepping up to help. Ivinson Memorial Hospital in Laramie, for example, will send its women’s health team to see patients in Rawlins twice a month for now. That will at least partially address the matter of prenatal care. However, most deliveries will still occur in Laramie.

Which bring us back to that icy highway. Even in the best of conditions, it takes about 90 minutes to drive from Rawlins to Laramie. But during Wyoming’s long winter, that stretch of Interstate 80 is often shut down by heavy snows and high winds. Getting from one town to the next by car becomes near impossible. Even when the roads are open, the drive takes longer.

We worry that reality may extend beyond the towns that are losing or have already lost obstetric services. Because the difficulties that led to the cuts in Laramie and Kemmerer could mean services in other towns are eventually lost. Which means our state leaders need to step up and address this growing problem now.

The first thing that needs to happen is an acknowledgement that this is a problem that can and should be tackled. That requires political will, as well as an acceptance that any solution won’t be cheap. Before you question spending state dollars on the problem, remember that lawmakers this last session gave coal companies a $10 million-a-year tax break. If we can spend that kind of cash helping coal companies, surely there is the money to address the health and safety of pregnant women.

It might require subsidizing air transport to get women in labor — especially those needing emergency services — to hospitals equipped to help them. Medical air transport is obscenely expensive, and we worry that if this issue isn’t addressed, women risk going medically bankrupt for the mere fact that they needed an emergency C-section to save their lives or the lives of their babies. Lest you think that’s big government, we already do subsidize air travel in Wyoming, but of the commercial variety.

The solutions won’t be cheap, but they should be discussed and then implemented. We are a state that values our rural communities, that praises small-town life. But people choose where to live, in part, based on the availability of medical services they need. If small-town hospitals continue to lose pregnancy care, people who want to start families won’t stick around. Wyoming can’t afford that. We need to act before more communities lose these precious services.

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