Wyoming lawmakers are considering obstetric care issues.
The Joint Committee on Labour, Health and Social Services took up this issue as a provisional item on its agenda. Testimony from health and state officials highlights declining births, difficulty recruiting and retaining obstetricians and gynecologists, and closures of labor and delivery units across the state.
Since 2018, three labor and delivery units have closed in the state. They said the economic costs of staffing postpartum departments continue to decline.
Jen Davis, health and human services adviser to Gov. Mark Gordon, said part of the problem for hospitals and obstetricians and gynecologists stems from the very nature of Wyoming, a rural state with a small population.
“They don't just have enough volumes to justify the service offerings in their budget, but also enough volumes to make sure they keep their skills up to date and have the capacity to carry out those deliveries. No,” she told the committee.
Davis was presenting the results of a survey of Wyoming hospitals managed by the Governor's Health Task Force OB Subcommittee. This was aimed at getting a better picture of what's happening in maternal care across the state. Fifteen hospitals responded, including a single birth center in the state. When asked what the main impediment to delivery services was, the majority of hospitals cited the inability to hire trained and skilled staff to provide the services. Other major reasons included the inability to hire obstetricians and gynecologists, unaffordability of hospital services, and insurance and service liability.
Davis and the Wyoming Department of Health (WDH) noted that another major barrier to maintaining this type of care in communities is the low number of babies born in the state.
“Based on a small volume, [of births], people are not able to maintain their skills to become competent in making deliveries,” Davis said. “We don't have a high-level NICU here, so the risk is high.” [births] Already out of state. So this is just thinking about how we can improve low-risk births in Wyoming. ”
Wyoming Department of Health
WDH officials said the delivery department requires a large number of nursing staff and there are sufficient doctors and lokum tenens (temporary doctors) on standby. These are typically fixed costs regardless of the number of births. According to WDH's Wyoming Hospital Birth Trends graph, the number of births in every county is flat or declining except for Hot Springs County.
“The number of women of childbearing age who give birth in the state is low,” said Franz Fuchs, chief policy analyst at WDH. “We don't know if volume is to blame for everything. A lot of it has to do with the bottom line and management of the hospital and the decisions they make.”
Mr. Fuchs noted that Mr. Lander may have cause for concern because the number of births has fallen significantly recently.
Davis ultimately likened the issue to one of the reasons the state is unable to keep young people in the state.
“We're not going to keep young people in this state, and we're not going to bring young people into the state if they can't have children,” she said.
Some witnesses cited the state's low birth rate and nursing shortage, as well as Wyoming's recently enacted anti-abortion law, which is currently suspended due to legal issues. . Eric Boley, president of the Wyoming Hospital Association, said uncertainty is an issue in recruiting doctors.
“If they find out where we are now, they’ll be worried and we won’t be able to recruit,” Boley said. “They want to go elsewhere because there is ambiguity and there are concerns about existing laws.”
Boley said lawmakers' commitment to making abortion illegal in the state is well known. Solutions include rewriting the law so that doctors are not penalized or criminalized for performing abortions, or making it more clear when doctors are criminalized for performing abortions, he said. He said that it is possible.
The committee concluded its discussion by saying it would consider potential solutions. These include creating some sort of program for primary care physicians to receive training in obstetrical and gynecological skills, and bringing obstetricians and gynecologists to neighboring states to stay up to date on more complex procedures, such as C-sections. This included dispatching them for one week at a time. Lawmakers may also consider some sort of agreement for certified midwives and gynecologists to work together.
The committee is scheduled to meet again in June.
