During her previous pregnancies in California, Funk was a 20- or 30-minute ride from the hospital, she said. This time, she’s prepared to stay at the Ronald McDonald House — or an affordable hotel — in Coeur d’Alene if she needs more frequent monitoring.
“I know how drastic my conditions can be,” she said. “Hopefully it won’t be a surprise if something happens overnight.”
Sandpoint resident Lauren Sanders, 34, who’s due to deliver her second child in November, faced the type of situation Funk fears this summer: For a few days, she didn’t feel fetal movement.
So Sanders got in the car for a “really intense” 45-minute ride to Kootenai. Throughout the drive, she said, she kept wondering: “Is my baby still alive?”
The drive to Bonner General would have taken five minutes.
The Kootenai doctors determined that everything was fine and released Sanders after some monitoring. But if something goes wrong during her planned home birth with a midwife, she might wind up on another agonizing ride.
“I’ve had to get comfortable in the discomfort in having a ‘riskier’ birth at home,” Sanders said.
Chronic, elevated stress and anxiety during pregnancy are associated with a higher risk of high blood pressure and heart disease for the pregnant woman, preterm birth, and asthma and behavioral problems in young children, studies suggest.
Financial burdens further impede access to care
Katie Bradish, 36, said she shells out hundreds of dollars to go to prenatal appointments in Spokane, 90 minutes from her home. Each trip requires her to take time off her job as a vice president at a grilling supplies company, she said, and pay $200 for a babysitter to watch her 2-year-old daughter, plus gas money.
In May, early in her pregnancy, Bradish began feeling sharp abdominal pain and decided to go to the Bonner General emergency room because of the distance she would have had to drive to reach an OB-GYN’s office. The visit, which included an ultrasound scan and exam, showed no major problems, and she later received a bill for more than $475 out of pocket. The copay for an ultrasound appointment with an OB-GYN would have cost her $23, she said.
“It’s absolutely a burden,” Bradish said. “This is thousands of dollars we would have in our family’s economy.”
For low-income residents of Sandpoint, such travel brings particular challenges. Around 14% of the city’s population live in poverty, which is above the state and national averages.
Drs. Amelia Huntsberger, Kristin Algoe and Lindsay Conner — former Bonner OB-GYNs who now work in Oregon, New York and Colorado, respectively — each said some of their Sandpoint patients had to start strategizing about whose car they could borrow or how they would pay for gas to travel for maternity care after the department closed.
Huntsberger, who was on the Idaho Health and Welfare Department’s now-disbanded Maternal Mortality Review Committee, emphasized that poverty and maternal mortality are intertwined. In Idaho, she said, Medicaid recipients accounted for the majority of pregnancy-related deaths in recent years. Despite the committee’s recommendations to expand postpartum Medicaid coverage to last 12 months, Idaho was one of just three states where legislators finished this year’s session without doing so.
“A lot of those people for whom it’s going to get harder, they don’t have a lot of power,” Huntsberger said. “There’s no microphone readily accessible to them, so many of them are going to suffer in the shadows.”
Losing ‘personal’ care
Olin said her birth experience in Spokane made her miss the care she got at Bonner General, where Morton was present throughout her 16-hour labor. At one point, the doctor even made a peanut butter and jelly sandwich for Olin’s husband, who is vegan and didn’t have anything to eat.
“They took such great care of us,” she said. “The care was personal.”
Krista Haller, a therapist in Sandpoint who works with pregnant and postpartum women, said she has heard similar sentiments from many local moms. Some lament the impact on their former doctors, Haller said, telling her: “These people are wonderful. They helped me so much in this very specific time of my life, and now they’re being hurt by these laws.”
The Bonner General spokesperson wrote that hospital leaders “support our providers who made the hard decision to move.”
Haller said she has also counseled local mothers who are thinking about getting pregnant again but worry about doing so without easily accessible obstetrics care.
“It’s a lot scarier, and they’re a lot more aware of the decision to have a child and whether or not it’s worth it to move forward to have a child and go through that journey knowing that the health care just isn’t there,” she said.