Things have been hard around here. Winter in Wyoming is usually fairly brutal, but the last two years have gotten significantly more so. The last birth I attended early Tuesday morning was almost 100 miles from my house, over a two-lane mountain pass with no services, no lighting, and with winds of 35-50 mph or more. Some places were complete white-out conditions and much of the road surface was a sheet of ice. And the ambient temperature was -30 F. Most of the traveling I do to winter births is under these conditions and it has frankly begun to feel reckless. In the last four months, I have been in two car accidents because of either visibility or ice.
And so because of this, I have had to make a difficult decision to no longer accept winter birth support clients outside of my immediate community. This decision was hard to make and one I spent considerable time thinking about (often while driving in these stressful conditions). Wyoming is a health care and maternity care desert, so midwifery and doula services are unavailable in most communities. Because of this, I have driven probably thousands of miles over the last two years to try and fill this vast gap. But I can’t in good conscience continue to travel dangerous roads that I wouldn’t otherwise even dream of being on to do this.
Scarcity sucks, but it also in theory should create a supply response (I was sort of paying attention to this premise in Economics 101). Does this mean that maybe we aren’t demanding loud enough to stimulate an increase in these resources? I think midwives, doulas, and birth workers are, but we need mothers and families - the “consumers” of health care - to demand the loudest. And this demand has to start at the community level. It isn’t sustainable, at least in my opinion, for a small handful of people to try and meet the needs of an entire state. This is just putting duct tape over a crack in the Hoover Dam - it’s a bandaid fix at best, but one that allows policymakers, public health entities, and those who need health care services to put off coming up with truly permanent solutions. We are propping up the scarcity model rather than encouraging towns and communities to begin developing village prenatals, doula groups, mothers' circles, and most importantly grassroots organizations aimed at changing midwifery regulations to allow multiple pathways to licensure in Wyoming.
If we want to see true change, we must demand it. Better yet, we must do it ourselves and start at home.
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