Let’s talk distance! Wyoming is a unique state in that it is largely rural, low populations, and the largest town in the entire state is only 60,000 people. There are only 5 towns in the state that have more than 10,000! This affects maternal health care in big ways! Most families in the state will find they have to travel to receive pregnancy care, whether it’s at a hospital, a birth center, or even a home birth!
When I was pregnant with my 4th baby, I chose a home birth. I lived in Laramie at the time, and the closest midwives were in Fort Collins. Because of the distance, my prenatal visits were at my midwife’s home in FoCo, about 65 miles away. She came to my house for the 36 week visit, the birth, and the first postpartum visit, but the other 10-15 visits were on me.
With hospitals around the state closing their OB units, this distance is affecting more and more families each year.
At Earthside, many of our clients come from distances more than 30 min away. We have South West Nebraska clients, as out of hospital births are not legal in the state of Nebraska. We have clients that travel to us from Casper, Laramie, Wheatland, Torrington, Saratoga, Douglas, and LaGrange! We have Colorado clients too, from Fort Collins to Greeley.
Add the wild weather in this part of the country and you have a very adventurous journey with prenatal care and planning birth!
How do we help our out-of-town clients with the distance and weather problem?
We are now integrating telehealth visits for appropriate clients who have to travel longer distances. By offering a hybridized prenatal appointment schedule we can cut down on the amount of in person trips our families would make. While we still adhere to the same prenatal schedule that is standard of care, some of these appointments can be virtual! We ask our clients to purchase items like blood pressure cuffs, a scale, urine dipsticks, and thermometers. This ensures health checks are being done and there is still FaceTime with a provider. Important visits that involve bloodwork, the “dress rehearsal” visit at 36 weeks, and toward the end of pregnancy would all still take place at the birth center.
When we have clients travel for birth we also have a lot of discussions about when to head to Cheyenne, depending on weather, and what phase of labor. For instance, if there is a storm headed our way and we have a client that is 2 hours distance and 41 weeks, they may want to come to town for a night or 2 to avoid hazardous travel. Or while we encourage our clients to stay at home as long as possible, a client traveling from Casper may want to come in earlier labor, find an Airbnb or hotel, and settle in there. This way they are not stressing about waiting too long, having an uncomfortable car ride, or having anxiety cause labor to feel more intense.
We have also partnered with Little America for client discounts! This one is super exciting because it’s a very unique hotel in town that offers our clients discounts when they come to town for labor or after birth.
Which brings us to the postpartum time: For our local clients, we do the first 24-48 hr visit at their home to ensure mom’s lochia is within normal limits, baby is breastfeeding, and everyone is stable. We also do the hearing screen, a metabolic screen and a heart screen for baby at this visit. Our out of town clients are asked to stay in town for the first day or two so they don’t miss that crucial checkup.
If you are within a few hours of our center, we can still take care of you!