WAUSAU, Wis. (WAOW) — Whether you’re a mom or not, most women see an obstetrician-gynecologists, or OB-GYN, for their health and routine care. But it may be getting more difficult.
Statistics show that seeing an OB-GYN in the Badger State is getting increasingly harder, especially for women who live in rural areas.
In 2014, Wisconsin had 556 physicians to serve more than 2 million women. That means there were only 2.38 OB-GYNs per 10 thousand women, according to the American Congress of Obstetricians and Gynecologists, or ACOG.
In fact, many counties don’t even have an OB-GYN. Jamie Babbitts, the Service Line Administrator for Women and Children’s Services at Aspirus, says 20 of the state’s 72 counties are without one.
In central Wisconsin alone, Adams, Clark, Forest and Price counties don’t have an OB-GYN, while Lincoln and Langlade counties only have one, according to the ACOG.
The shortage is not something new. It’s been an issue in Wisconsin and throughout the nation for a while.
The problem, essentially, grows from demand exceeding supply.
In recent decades, the number of U.S. women over age 18 has increased by 33 million; yet, OB-GYN first-year residency positions grew by fewer than 200 between 1992 and 2016, according to the Association of American Medical Colleges.
The ACOG reports there has been essentially no increase in the number of trained OB-GYNs since 1980, while the population of women in the U.S. has increased 26 percent since then.
The shortage is difficult for women. Many are left having to drive long periods of time to see a specialist.
“It’s not uncommon to have patients who are driving 45 minutes, 60 minutes, and then often for our high-risk patients we’ve even seen where they have to travel over 2 hours to come and see the high-risk OB doctors at our facility,” said Dr. Sarah Goetz, a general OB-GYN at Marshfield Medical Center.
And those trips, on average, are being made 12 to 13 times during a pregnancy, according to Dr. Goetz.
That travel can add on extra transportation costs, put strain on the mother and the family, and often force women to make trips and appointments by themselves.
Dr. Goetz also said being in a car for that long can have health risks, like blood clots in legs.
“We talk to our third trimester pregnant patients about not sitting in a car for a long period of time because of those risks of blood clots,” she says.
The shortage also affects non-pregnant women who want to see their physician for well checks or annual visits.
“In non-pregnant women, what can happen is if they have to drive too far to get care, then they don’t get care. So they don’t get screening tests, they can have symptoms that they’ll seek care later, and so then the prognosis is worse,” said Dr. Paul Kerns, an OB-GYN physician at Aspirus.
Why the shortage:
The shortage is due to a number of reasons.
“There are not enough medical schools graduating enough physicians, the demographics, there are more and more older patients in the population so we need more and more physicians, and then a lot of physicians are a part of that demographic that are retiring also,” Dr. Kerns said.
The shortage in Wisconsin is also due to the many rural areas throughout the state.
Babbitts said it’s harder to recruit people to smaller areas, especially when they’re young.
“There are many, many young professionals going toward some of the larger cities for more of the opportunities, as well as the culture, the environment and things like that,” she said.
The decline in OB-GYNs doesn’t seem to be going anywhere either.
The anticipated shortage of OB-GYN physicians will be 18 percent (9,000) by 2030 and 25 percent (15,723) nationwide by 2050, according to the ACOG.
What’s Being Done:
Sen. Tammy Baldwin is addressing the issue on a federal level.
She recently co-authored a bipartisan legislation with Senator Lisa Murkowski from Alaska, called the Improving Access to Maternity Care Act.
The bill aims to identify areas in need of OB-GYNs and provide incentives to get more providers to practice in those areas.
In a statement, Sen. Baldwin said, “Too many communities around Wisconsin are still facing a shortage of qualified, maternity care professionals and services. My bipartisan Improving Access to Maternity Care Act will help target resources so providers can deliver the care that expecting mothers in Wisconsin so desperately need no matter where they live. I’m proud to lead this bipartisan effort to ensure that healthier pregnancies lead to healthier babies.”
The bill has passed both the House and Senate, and President Trump signed it into law in December.
Meanwhile, hospitals like Aspirus are looking for opportunities to expand what they can do in terms of providers.
Babbitts said they will use clinical nurse midwives or physician extenders to help spread out resources and give them more opportunity for access. She said Aspirus also has some family medicine providers that deliver babies.
Why it’s important:
With women having babies at older ages nowadays, Babbitts says there are more pregnancies that are higher-risk.
Meanwhile, pregnancies today are also more successful for women who suffer from health problems, like heart conditions or diabetes, making OB-GYNs even more important.
“Now we have higher-risk women, older women, who are having babies and they need someone who can really understands and can care for them in a variety of different health conditions,” Babbitts said.
Not to mention, with fewer OBGYNs, patients have to wait longer when at appointments.
“We do have high volumes. We would love for our patients to get in to see us in a timely manner, and sometimes for those first well visits it can be a little bit longer because our patient panels are larger when you’re pulling from a variety of different areas,” Babbitts said.
The more OB-GYNs across Wisconsin, the better it is for women and their babies.
“Women have better outcomes for their own health and then babies have better outcomes for their health if they’ve been having routine prenatal care, screenings for any problems with pregnancies, and women are more apt to get that care if they have providers that they trust that are local to them,” Dr. Goetz said.