Report highlights rising pregnancy, birth concerns

CASPER – Wyoming has improved in a number of areas when it comes to child and maternal health, according to the 2022 Wyoming Counts Kids data book. But access to health care, maternal mortality and preterm deliveries are areas where the state could do better. 

Births among women with less than a high school education declined from 16 percent in 2000 to 9 percent in 2020, according to the book, which is published by the Wyoming Community Foundation and the Wyoming Survey & Analysis Center at the University of Wyoming.

Teen births decreased by about 57 percent between the same years, and the percent of women who smoked during pregnancy was cut nearly in half. 

Births to unmarried Wyoming mothers and cesarean-section births also declined between 2011 and 2020.  At the same time, the report finds that about 24 percent of women still received less than adequate prenatal care in 2020, although that has still decreased from 26.4 percent of women in 2011.

The Wyoming Department of Health recommends that women have two or more follow-up doctor visits within three months of delivery.

Labor and delivery services in Wyoming are at risk. Earlier this year, two hospitals – Memorial Hospital of Carbon County in Rawlins and the South Memorial Hospital District in Kemmerer – cut these services because of their inability to keep up with costs. 

Wyoming Hospitals Association President Eric Boley underlined this as a concerning trend in the Legislature’s Labor, Health and Social Services Committee meeting last month.

“It’s just a sign of what’s happening across the country in rural health,” he said. 

And that trend probably won’t get better if Wyoming doesn’t turn around its health care worker shortage. 

“Until we find a solution to that, I see more services having to be cut,” Boley said. 

The Wyoming Counts Kids report shows other concerning numbers; the percentage of Wyoming babies born with low birth weights increased from 8 percent in 2011 to 9.7 percent in 2020, and preterm deliveries increased from 9.9 percent to 10.1 percent during the same time frame. 

Maternal mortality in Wyoming also rose to 34.8 deaths per 100,000 live births in 2019, up from 24.6 deaths per 100,000 live births in 2018. That’s about a 41-percent increase in maternal deaths in one year. 

In 2020, the Wyoming Department of Health and the Utah Department of Health formed a cross-state maternal mortality review committee, which aims to use data to understand what causes maternal deaths and make recommendations to prevent these deaths going forward.

In 2021, the committee reviewed 12 maternal deaths that occurred between 2018 and 2020. It determined that half those deaths were pregnancy-related, according to a presentation from the Wyoming Department of Health. 

Substance use was involved in all six of those cases. Mental health conditions were an underlying factor in four of the six deaths. 

Three of the mothers had lost insurance coverage before they died. Medicaid, the jointly-funded federal-state health insurance program, paid for an average of about 33 percent of Wyoming births in 2018, 2019 and 2020.

Before the COVID-19 pandemic, Medicaid covered moms for 60 days after delivery. Their babies were also covered until their first birthday. About 70 percent of these women lost Medicaid eligibility after the 60-day postpartum period, according to the Wyoming Department of Health. 

But during the pandemic, Medicaid’s postpartum coverage was temporarily extended to one year after delivery, and more kids and moms were eligible for Medicaid insurance. 

The Wyoming Counts Kids report states that 31 women in Wyoming made claims for serious medical conditions and 561 women made claims for mental health care as a result of the extended postpartum coverage. 

The report suggests permanently extending the yearlong postpartum Medicaid coverage to improve child and maternal health, something that the Legislature’s health committee is considering. 

Other states have extended this coverage. Wyoming is one of 16 states that hasn’t, according to the report. 

The one-year postpartum extension would likely cost about $3.8 million per year, half of which would be paid by the federal government, according to the Wyoming Department of Health. The health department estimates that about 1,250 pregnant women would benefit from the extended postpartum coverage.