State lawmakers are working on a legislative proposal that would give certified nurse midwifes more direct access to hospitals in Wyoming – and in Fremont County specifically.
The issue arose during a recent meeting of the Wyoming Legislature’s Labor, Health and Social Services Committee, which already discussed the emergence of maternal healthcare deserts in the state – including in Fremont County – earlier this year.
At that time, Wyoming Rep. Sarah Penn, R-Lander, suggested one way to address the issue would be to give midwives “more autonomy” to practice in the state, citing her own experience with a midwife who was required to have “oversight by a physician” in order to perform a delivery at her local hospital.
Certified Nurse Midwife Anna Lee, who has experience working in Lander and Cheyenne, said she has been told to get “permission from an obstetrician” in order to perform a hospital delivery – a requirement that the same facility didn’t apply to other providers like family practice physicians “who have far and away less training than I do.”
“This is thwarting us,” she told the Labor Committee last week. “The majority of certified nurse midwives have left, (and) I am about to leave the state to go practice somewhere else.”
SageWest
Wyoming Rep. Ken Clouston, R-Gillette, asked whether Lee could approach the board of directors governing the hospitals in question and ask them to revise their bylaws to eliminate those requirements for certified nurse midwives, but Lee said that’s “not an option in Fremont County,” because SageWest Health Care is owned by a New York City-based private equity firm, and “they don’t seek our counsel.”
County 10 reached out to SageWest for a comment on this story last week but did not receive one, though hospital officials said they are discussing the issue.
SageWest does have a Board of Trustees made up of local residents and physicians, according to its website.
Regardless, Lee’s comments – combined with earlier statements from physician Jacques Beveridge, who said he “got burned out” and moved to Cheyenne after spending 10 years working in private practice in Lander – prompted Wyoming Rep. Andrew Yin, D-Jackson, to wonder whether “we need a little more oversight on for-profit hospitals in the state, (if) it’s causing issues for actually providing health care.”
Wyoming Nurses Association Lobbyist Toni Decklever said lawmakers could also consider revising state statute to specifically include certified nurse midwives on the list of healthcare providers that can admit patients to local hospitals.
The statute she cited – W.S. 35-2-113 – only applies to public hospitals, however, Wyoming Sen. Eric Barlow, R-Gillette, noted, and “we need something broader” in order to address the situation at private hospitals, too.
He offered to work with other lawmakers on the committee in collaboration with the Governor’s Health Task Force OB Subcommittee and relevant professional organizations in the state to develop an individual legislative proposal to try to address the issue, since the Labor Committee isn’t scheduled to meet again before the 2025 legislative session.