W.Va. Faces Shortage Of OB-GYNs And Places For Them To Work

In 2015, Nicole Nichols was pregnant with her third, a little girl. It was a pregnancy with multiple high-risk complications.

At the time, she lived in Looneyville, a small community in rural Roane County and about 19 miles from the county’s hospital. But that year and into the next, she had to drive to a hospital in Charleston for checkups, which is an hour each way.

She scheduled visits around her other kids’ school schedules, and she didn’t always have a reliable vehicle to travel while her husband worked out of town.

“I had to go just about every week. Toward the end I had to go two to three times a week for regular non stress tests because I had a pretty rough pregnancy with her,” Nichols, 31, said.

West Virginia is facing a shortage of obstetricians and places for them to work. Only 18 of its 55 counties have hospital birthing centers.

Roane County is located in the center of the state, an area that is a desert for OB-GYNs. Its local hospital once had a labor and delivery unit but it closed in 2006 due to declining use.

Nicole Nichols

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Courtesy

Nichols went into early labor multiple times, which includes risks for mom and baby.

“I was in full panic mode in labor very early and scared I was going to lose her,” she said. “That really put her at risk having to travel an hour and an hour and a half to get that labor stopped … had I not made it there in time I don’t know where she would be.”

West Virginia has 20 birthing hospitals after St. Mary’s Hospital in Huntington closed its labor and delivery unit earlier this month. The state has one freestanding birth center.

Nationwide and in the state, births saw a slight increase in 2021 for the first time in seven years, but the overall drop in births coupled with West Virginia’s aging and declining population have made it difficult to sustain birthing centers.

The shortage means there’s a declining number of places for OB-GYNs to work, and this all leads to poorer outcomes for mothers and babies, according to Dr. Angela Cherry. She’s a family medicine physician in Harpers Ferry.

“If there’s not a birthing center there, moms are having to drive more than 30 minutes to a birthing center, which may limit the care they receive even prior to delivery,” Cherry said. “There is an increased risk of having more complications … if they have less prenatal care.”

Cherry said that while telehealth could help fill in the gaps for prenatal care, the state’s internet gaps keep it from being an option for all pregnant women.

West Virginia has some of the country’s worst birthing outcomes, including its rate of infant deaths and preterm births, which can cause a number of serious complications like breathing problems or heart issues.

The state is also having an increase of mothers dying in childbirth, which is connected to the state’s drug epidemic.

“What we’ve seen is those women are just not getting care,” she said.

Cherry presented these concerns to lawmakers in November during legislative interim meetings.

West Virginia isn’t the only state struggling; there’s a national shortage of OB-GYNs.

Cherry said the state’s rural towns struggle to attract OB-GYNs because they’re too far from hospitals and lack local economy. West Virginia University School of Medicine offers a fellowship program that trains family medicine doctors to perform cesarean deliveries, or C-sections, in rural areas that don’t have a birthing hospital and increase obstetrical care. But, Cherry said the program has struggled to place program graduates in West Virginia towns, and those doctors choose to practice in rural communities in other states.

The state could also struggle to recruit OB-GYNs following its recent abortion law, which is one of the most restrictive abortion bans in the country.

Nationally, doctors and a health care recruiting firm have said states with restrictive abortion measures have trouble recruiting OB-GYNs because doctors fear they could be prosecuted for health care decisions.

State Sen. Hannah Geffert, D-Berkeley, said her area is struggling to recruit OB-GYNs. During a presentation on maternal health, she asked Dr. David Didden with the state Office of Maternal, Child and Family Health if the abortion law would further impact recruitment.

Didden responded, “I think we can send the message that we are in support of reproductive health for women, and that this is a promising place to come and practice medicine. But, it’s a tough sell and it’s not just in medicine … We are going to continue to establish best practices and standards of care, and I hope we’ll be able to convince more providers that this is a good place to practice medicine.”

Nichols’ daughter is now six years old and thriving, and the family has moved from Roane County.

She hopes state leaders will focus on bringing OB-GYNs to rural areas as she knows other mothers from Roane who have struggled to get necessary appointments for mother and baby due to travel distance, money and transportation challenges.

“For people who can’t get to Charleston, it’s a lot easier for them to find a ride that’s 10 to 20 minutes compared to an hour or hour and half,” Nichols said.