Carbon County mothers uncertain after hospital cancels labor services

LARAMIE — For expecting mothers in Carbon County, an exciting milestone has taken an unexpected turn into one of added stress and fear. 
Memorial Hospital of Carbon County announced last week that it would stop offering labor and delivery services because of financial issues, leaving local parents at least an hour or more from the nearest medical facility that delivers babies. 
“It’s hard to put my thoughts into words,” said Marissa Shives, who had planned to have her baby at Memorial Hospital of Carbon County in two months. “It’s a grieving process and stressful time at the end of my term. I’ve lost trust in the health care in Carbon County.” 
The loss of services, which go into effect June 16, comes as a blow to rural Wyoming patients who already deal with difficulties in accessing basic health care because of the remote geography of the state. 
“Wyoming is limited in terms of options for pregnant women,” said Jacqueline George, a doula who is based in Medicine Bow but offers her services around the state. “It’s already difficult for some people to get to hospitals.” 
Even for mothers who prefer to have a home birth, options in Carbon County are limited because of availability and laws that restrict certain types of home births, such as a breach or twin birth, George said. It also can be necessary to send mothers to hospitals if they have certain health issues, complications or need medications. 
There are only 17 midwives registered in the state of Wyoming, with nine of them actually based in neighboring states such as Colorado and Utah, according to the Wyoming Board of Midwifery.
The cancellation of birth and delivery services at Memorial Hospital of Carbon County was a last resort option to save money after the hospital went through a period of extreme financial hardship brought on by the COVID-19 pandemic, hospital CEO Ken Harman said during a Friday Facebook Live session addressing the decision. 
Staff at the hospital exhausted a host of other options, such as cutting positions and terminating contracts, before making the final decision to cut the service was made. 
Having to halt delivering babies was a difficult and heartbreaking decision for hospital administration and staff, and is a last-resort option, Harman said. 
“We have individuals here at this organization who are devastated,” he said emotionally through tears. “I’m personally devastated. I apologize to the community that we are in this situation. I truly wish we were not.” 
The hospital operated at a $2 million deficit last year and saw a period of financial loss happen faster than ever in his career, with a 40% reduction in cash reserves, Harman said.
Because of staffing issues, the hospital has had to hire traveling nurses who come into the community to work for short periods of time. Harman also cited large cost increases in nursing wages as the main source of the financial stress. Before the pandemic, the cost to get a traveling nurse was around $65 an hour. Now, it’s more than $200 an hour. 
On top of that, the hospital was only providing for roughly 60 deliveries a year, making that service a source of financial drain. Hospitals in more populated areas could see a birth rate between 15 and 20 deliveries a day, he said.
For many women, having a strong relationship with their doctor or midwife is central to feeling confident about the prospect of having a baby. For those in the same situation as Shives, this confidence is being stripped without much notice. 
“Dr. (Jennifer) Motley is a great asset to this community and she’s been with me through a loss and now a successful pregnancy,” Shives said of her local doctor. “Now she won’t get to see the baby we’ve watched grow on a screen together and I have to put trust in someone I’ve never met.” 
Shives now plans to have her baby at Ivinson Memorial Hospital in Laramie, which could be a similar path other Carbon County parents take. 
Since the Rawlins hospital announced its decision, Ivinson has been making preparations to have more demand for delivery services. 
“We know we have the capacity for more and we want to support Carbon County as much as we can,” said Ivinson Chief Nursing Officer Nicole Rooney. 
In June, a newly constructed Women and Children Center will open at Ivinson, offering larger, updated delivery rooms, a new triage room and family waiting rooms. The hospital has been able to manage staffing issues with the use of traveling nurses and has recruitment and training programs in place. 
The two hospitals have been in contact about how they could collaborate to offer services to parents. Though no plans have been solidified, Ivinson may consider bringing some services to its outreach clinic in Saratoga, Rooney said. 
It takes roughly 90 minutes to drive to Laramie from Rawlins along a section of Interstate 80 that is often closed or impassable because of snow and wind in the winter. 
“During our winter months it is almost impossible to get out of town safely,” said Teresa Leroux, a Carbon County woman whose daughter is expecting a baby. “This is putting mothers and their unborn children in danger.” 
Harman said the emergency room staff at Memorial Hospital of Carbon County would be prepared to deliver babies or possibly facilitate transfers to Laramie or Rock Springs in emergency situations. For Leroux, this option pales in comparison to the presence of what she called the “top-of-the-line” delivery staff the hospital lose. 
“How is an ER doctor and their staff going to handle emergency (delivery) situations?” Leroux said. “They are already overwhelmed with just your everyday emergencies.” 
Even with the closing of the unit, other women’s health services will still be available at Memorial Hospital of Carbon County. 
Moving forward, the hospital is working to build more sustainable nursing programs to avoid problems like this in the future. One of these initiatives includes a scholarship training program for nursing students. 
To close the Facebook Live session, Harman asked residents to continue supporting the hospital so that it could survive financially. 
“We need you. Want to be here,” Harman said. “We’re changing the culture here and really trying to do this right. I apologize for having this happen, but we need your help.”
 
This story was published on May 8.