Here & Now

Dr. Amy Domeyer on the lack of OB-GYNs in Wisconsin

Zac Schultz:

Turning to healthcare, a nationwide shortage of OB-GYNs will force some pregnant women in northern Wisconsin to travel even farther to give birth. Earlier this week Mayo Clinic announced they would no longer provide delivery services in their facility in Barron County and will shut down delivery at their Menomonie clinic at the end of the year. Patients will need to travel to Eau Claire to give birth. Joining us now is Dr. Amy Domeyer, a practicing OB-GYN and legislative chair for the Wisconsin chapter of the American College of Obstetricians and Gynecologists. Thank you for your time.

Amy Domeyer:

Thank you.

Zac Schultz:

In their announcement, Mayo Clinic said they spent two years “aggressively recruiting for several open positions.” How bad is the shortage?

Amy Domeyer:

So, you know, we know that access to OB-GYN care in rural counties is declining. And part of that is with some of these hospital shortages and shuttering of OB units. Less than half of rural women live within a 30-minute drive to the nearest hospital. So that can lead to really significant disparities in care and then really significant changes in terms of outcomes as people aren’t always able to access a doctor early enough in their prenatal care or a birth center in a timely fashion when it is time for them to deliver their baby.

Zac Schultz:

What’s leading to the shortage? Are there just not enough OB-GYNs period? Are they not being offered enough in pay to live in a rural area?

Amy Domeyer:

I would say there are many factors that are involved in the shortage of OB-GYNs. It is challenging in that maternity care in general is undervalued compared to other health services so that can impact decisions for folks going into OB-GYN but also for hospitals in terms of continuing OB-GYN services because it does require a complex team of –you know, a system of folks to ensure we’re providing safe access to care. I would say, you know, certainly there are incentives for folks to try to get people to these rural areas and I think the institutions in Wisconsin are — have an eye to that. Specifically the University of Wisconsin has a rural track for their OB-GYN residents, which is one of those unique things in the country. So — but I think we’re feeling in general healthcare shortage with respect to a lot of the things that are happening more recently with the COVID pandemic, with recent legislative interference into OB-GYN practice that are further exacerbating some of the challenges that likely Mayo has been seeing for a while.

Zac Schultz:

You talked about legislative interference. What about the Supreme Court decision to overturn Roe v. Wade? How has that affected your industry?

Amy Domeyer:

Yeah. I would say in general I think this is unique in terms of — right now in Wisconsin there is some debate over which law can be enforced or which law is the law of the land with respect to abortion care. But because of an 1849 law which would ban abortion care, that would make people who are practicing OB-GYN care, if they needed to provide abortion services, a felon and so you can kind of see that if a specialty has — is faced with a law that could potentially make them a felon, how that would be scary for someone who maybe wants to come to Wisconsin to practice OB-GYN care or provides abortions as part of their practice, they might not be interested in coming here. And then as well as recruiting students and residents to join our field, I don’t know of other specialties that are faced with such criminal penalties, so obviously as this situation in our state and in others across the country since that decision was made.

Zac Schultz:

There have been some stories nationally, even from Wisconsin, about horror stories of women who needed to decline in health even more to meet the exception for the life of the mother. What kind of situations are you seeing in terms of what qualifies for a woman’s health and how much legislative clarity do we need on this issue?

Amy Domeyer:

Yeah. The health of the mother exception is very, very broad. I guess I should say it’s not the health of the mother, it’s the life of the mother exception is very broad. We don’t really know what that means from a criminal standpoint because these cases have not been, you know, this law has not been enforced in a very long time. So, you know, in general, physician groups are coming together to try to understand or to build a consensus around what we think that means. But that can be difficult because different physicians may be comfortable with a different level of risk and that unfortunately then leads to differences in terms of patient care. So certainly things like hemorrhage, bleeding excessively would be one of those things. Problems with significantly high blood pressure. There’s all kinds of things that could warrant those services but we’re still in a place where doctors and I think the public and lawyers, lawyers for hospital systems, are asking how sick is sick enough? And facing those sorts of legal challenges, the idea that one could be a felon who is just trying to do their job and take care — the best care they can of the patient in front of them. That can be scary for folks either entering the field or thinking about coming to Wisconsin.

Zac Schultz:

Dr. Amy Domeyer. Thanks for your time today.

Amy Domeyer:

Thank you so much.