{"id":72327,"date":"2023-10-30T08:58:57","date_gmt":"2023-10-30T14:58:57","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=72327"},"modified":"2023-11-09T07:56:43","modified_gmt":"2023-11-09T14:56:43","slug":"maternal-care-desert-providing-health-care-in-rural-craig-colorado","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/maternal-care-desert-providing-health-care-in-rural-craig-colorado\/","title":{"rendered":"Maternal desert: Helping moms and babies in rural Colorado, come rain or shine"},"content":{"rendered":"
<\/div>
\"A
The McAlexander family – Christopher, Estella, Breanna and Oliver – with Dr. Laurie LeBleu Vaszily. All photos by John Russell, for UCHealth.<\/figcaption><\/figure>\n

Not even a flood could stop them.<\/p>\n

Come hell or high water, four physicians from UCHealth Yampa Valley Medical Center<\/a> take turns making the drive to Craig, Colorado, a small mining community 50 miles to the west that, like many rural places, does not have a lot of doctors.<\/p>\n

Drs. Laurie LeBleu Vaszily<\/a>, Elaine Stickrath<\/a> and Kate Feller<\/a> make their way along U.S. Highway 40, a two-lane road that twists and turns along the Yampa River with a sheer rock wall along one side. In the Spring and Fall, the doctors keep a keen eye out for wildlife \u2013 especially deer, careful to give them the right-of-way they deserve.<\/p>\n

When U.S. Highway 40 closed to flooding in spring 2023, Dr. Jeff Chamberlain<\/a> spent 30-45 minutes on a detour of rugged dirt roads, determined and eager to see patients.<\/p>\n

Like her colleagues, Dr. LeBleu makes the drive several times a month. On a recent fall day, with a canopy of colorful leaves shading part of the road, she went to see Breanna McAlexandar, among other patients. Breanna is a mother of two young children who came to the clinic for a checkup six weeks after delivering a healthy son, Oliver, who weighed in at 8 pounds.<\/p>\n

\u201cIt\u2019s much more convenient to have this appointment in Craig,\u201d Breanna said.<\/p>\n

Having doctors come to Craig saves Breanna from having to load up newborn Oliver and his sister, Estella, who is named after Breanna\u2019s grandma and born on April 16, 2021, to travel to UCHealth Women\u2019s Care Clinic in Steamboat Springs<\/a>.<\/p>\n

Having doctors at the Women’s Care Clinic in Craig<\/a> has been \u201ca huge help\u2019\u2019 to her, saving her time in the car, a drive down a winding road and giving her peace of mind that the doctors are only a few minutes from her home.<\/p>\n

\"\"
The lights of cars and trucks making their way between Steamboat Springs and Craig create streaks along U.S. Highway 40 on Oct. 11, 2023. The commute, which stretches just over 40 miles, takes drivers through the towns of Milner and Hayden and onto Craig. The mountain road also challenges drivers with winter conditions, roads that run along steep cliffs and falling rock areas, and are increasingly filled with periods of heavy traffic, not to mention seasonal wildlife.<\/figcaption><\/figure>\n

\u201cWe don\u2019t have to plan our whole day around an hour drive to Steamboat, an hour for the appointment and an hour drive back,\u201d she said.<\/p>\n

Breanna is one of about a dozen or so women each day who come to the clinic for a variety of appointments, including annual checkups, Pap smears, general gynecology appointments, and post-partum and post-operative appointments.<\/p>\n

Craig, with cold and snowy winters and temperatures near zero, has long been a coal mining town that draws elk hunters to the picturesque town created at the confluence of the Yampa River and Fortification Creek. Its hospital ended OB\/GYN services in 2020.<\/p>\n

Maternal deserts: Bringing health care to rural Craig, Colorado<\/strong><\/h2>\n

According to the March of Dimes<\/a>, more than one-third of U.S. counties are considered maternity care deserts, which are defined as counties without a hospital or birth center offering obstetric care and without any obstetric providers. That means more than 5.6 million women live in counties with no or limited access to maternity care services.<\/p>\n

In Colorado<\/a>, 37.5% of counties are defined as maternity care deserts compared to 32.6% of counties in the U.S. overall. Moffatt County, where Craig is located, is one of 24 counties that meets this definition.<\/p>\n

\u201cThe number of patients impacted by maternal care deserts is increasing,\u201d Stickrath said<\/span>. \u201cRural hospitals are ending their maternity services<\/a>, be it due to financial constraints or lack of providers willing to live in more rural areas.\u201d<\/p>\n

In rural areas across Colorado, 49.1% of women live more than 30 miles from a birthing hospital, with 6.4% of women in Colorado not having a birthing hospital within 30 minutes.<\/p>\n

\u201cOutreach to rural areas is so important,\u201d said LeBleu. \u201cEveryone should have access to health care, whether it\u2019s in person or through video appointments. While we know patients seek care when they\u2019re not feeling well, we also want them to engage in and seek routine health care services, be it annual appointments, yearly blood work or scheduling key health screenings like mammograms. We don\u2019t want access to care to be an issue, which is why we\u2019re so committed to our patients and traveling to them.\u201d<\/p>\n

\"Family
The McAlexander family, including Christopher, Oliver, Breanna and Estella, meet with obstetrician and gynecologist Dr. Laurie LeBleu Vaszily at the UCHealth Women’s Care Clinic in Craig, Co. on Oct. 18, 2023.<\/figcaption><\/figure>\n

Meeting patients where they are helps strengthen the provider-patient relationship. It\u2019s a mission the physicians take seriously.<\/p>\n

\u201cI can\u2019t remember the last time the physicians cancelled,\u201d said Ted Morton, practice administrator in physician services at UCHealth Yampa Valley Medical Center<\/a> (YVMC). \u201cThey\u2019re committed to their patients.\u201d<\/p>\n

The appointments in Craig give doctors time to talk to pregnant moms about prenatal health, as well as what to expect when delivery draws nearer. Helping women who live in rural Colorado understand what to look for is important since the 30-minute mark is critical in an obstetric emergency.<\/p>\n

\u201cThe standard is 30 minutes from decision to incision,\u201d said LeBleu. \u201cIn a true emergency, such as a placental abruption<\/a> or an umbilical cord prolapse<\/a>, we want 30 minutes or less from recognition of the problem to delivery of the baby in order to try and eliminate detrimental effects to the newborn and mother.\u201d<\/p>\n

The placenta pumps 600-700 cubic centimeters (cc) per minute at term, and a woman holds approximately 5,000 cc of blood during pregnancy.<\/p>\n

\u201cIn a hemorrhage situation, a woman can bleed out her entire volume of blood in about eight minutes,\u201d said LeBleu. \u201cIf there is a large abruption or post-delivery hemorrhage between here and Craig, we have major patient safety concerns.\u201d<\/p>\n

The making of a beautiful family<\/strong><\/h2>\n

Shortly after their wedding five years ago, Breanna and her husband, Christopher, started trying to have a family. They eventually worked with a fertility clinic in Denver to conceive their first child.<\/p>\n

\"Family
The McAlexander family. Photo by John Russell, for UCHealth.<\/figcaption><\/figure>\n

\u201cMinus a more in-depth ultrasound at the clinic in Steamboat, we were able to do our other appointments at the UCHealth clinic in Craig, which was a huge help and only two blocks from my work at the time,\u201d said Breanna. \u201cOtherwise, I would have had to take a half day off work to drive to Steamboat, have the appointment and then drive back, on top of trying to get appointments to align with Christopher\u2019s work schedule.\u201d<\/p>\n

\u201cWe know if we offer care locally, patients are more likely to seek care. If we don\u2019t offer the service, patients may forgo or delay care,\u201d said Ryan Larson, director of clinic operations at YVMC. \u201cIn the case of women\u2019s care, we know if the physicians don\u2019t go to Craig, there could be patients who get behind on their OB visits, ultrasounds, annuals, etc. Providing care in Craig keeps our patients and the surrounding communities healthy.\u201d<\/p>\n

Certified nurse midwife Jennifer Allen<\/a> delivered Estella in the birth center at UCHealth Yampa Valley Medical Center<\/a> in Steamboat Springs.<\/p>\n

\u201cMy labor experience was amazing,\u201d said Breanna. \u201cThe nurses were fantastic, and randomly, Christopher had gone to school with one of them. It was comforting for him to know someone in the room because it gave us that small community feeling.\u201d<\/p>\n

After they celebrated Estella\u2019s first birthday, Breanna and Christopher began trying for a second child. Thinking they would need to go down the fertility treatment path again, they were shocked when Breanna became pregnant naturally.<\/p>\n

They found out she was carrying a boy \u2013 \u201cI\u2019m a planner and wanted to know\u201d \u2013 and at 39 weeks and six days, her water broke at home around midnight on Sept. 9, 2023.<\/p>\n

\u201cWe had been timing contractions prior to that, but they weren\u2019t within the 5-1-1 rule of them happening every five minutes, lasting one minute each, for an hour,\u201d said Breanna. \u201cChristopher\u2019s mom arrived to stay with Stella, and about 12:15 a.m., I called the birth center in Steamboat to let them know we were on our way.\u201d<\/p>\n

Baby Oliver makes his debut<\/strong><\/h2>\n

By the time they were approaching Hayden, still some 40 miles from the hospital, Breanna\u2019s contractions were increasing in strength.<\/p>\n

\u201cBy the time I got the words, \u2018He\u2019s coming,\u201d out of my mouth, the next contraction happened, and Oliver was in my arms. He was born at 12:53 a.m.,\u201d said Breanna. \u201cChristopher called 911, and we pulled over to wait for the ambulance.\u201d<\/p>\n

While they\u2019d packed hospital bags, they didn\u2019t think they needed to bring potential delivery supplies with them.<\/p>\n

\u201cI found a kitchen towel in the back seat and wrapped Oliver in it,\u201d said Breanna. \u201cThe officer who met and waited with us gave us a blanket to help keep him warm. Christopher and I were in shock at what had just happened, but hearing Oliver cry was such a relief.\u201d<\/p>\n

\u201cWhen a baby is delivered outside the hospital, we worry that the baby may need stimulation or suction if they don\u2019t transition quickly after birth,\u201d said LeBleu. \u201cI also worry about maternal hemorrhage after delivery as medications, a blood transfusion or even surgery can be needed to stop the bleeding. Breanna and Christopher did everything right in this situation. They called 911, and she put the baby against her body to keep him warm, which was great thinking. Luckily, Oliver started feeding right away. And Christopher remained calm and ensured the safety of everyone.\u201d<\/p>\n

Back at home, Estella has embraced her role as big sister.<\/p>\n

\u201cShe doesn\u2019t always understand how fragile Oliver is being this little, but she\u2019s doing well with him,\u201d said Breanna. \u201cWe\u2019ve been fortunate to have a lot of family time as we adjust to being a family of four.\u201d<\/p>\n

While it wasn\u2019t how they wanted to welcome their son into the world, Breanna and Christopher feel blessed and grateful that Oliver was born without any complications.<\/p>\n

\u201cShock, trauma, awe, amazement \u2013 we experienced all of those emotions,\u201d said Breanna. \u201cIt would have been great to have an uneventful birth story to tell and to have delivered closer to home, but it didn\u2019t work out that way. At least we\u2019re able to receive the care we can in Craig, thanks to UCHealth.\u201d<\/p>\n

Medical care close to home: Offering health care in rural Colorado<\/h2>\n

In addition to obstetrical and gynecological care, UCHealth also offers heart and vascular<\/a>, pain management<\/a>, primary care<\/a> with integrated behavioral health, and lab services in Craig.<\/p>\n

\u201cWe offer these services in Craig and to the surrounding communities because it matters to our patients,\u201d said Larson. \u201cAccess to health care is important to one\u2019s overall physical, social and mental status. It helps with disease prevention, detection, diagnosis and timely treatment. And it contributes to a better quality of life and longer life expectancy.\u201d<\/p>\n

Outreach in rural communities is made possible not only through investments by UCHealth, but by physicians who are eager to support rural Coloradans.<\/p>\n

\u201cOutreach is part of the job, and that\u2019s part of what attracts us to these roles,\u201d said Stickrath. \u201cIt is financially difficult for many patients to travel for a routine appointment. It is often not possible to miss that much work for most patients either. If we want patients to have care, it needs to be accessible.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Not even a flood could stop them. Come hell or high water, four physicians from UCHealth Yampa Valley Medical Center take turns making the drive to Craig, Colorado, a small mining community 50 miles to the west that, like many rural places, does not have a lot of doctors. Drs. Laurie LeBleu Vaszily, Elaine Stickrath […]<\/p>\n","protected":false},"author":2146,"featured_media":72329,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[8],"tags":[113,3921,3512,25,586,65,4010,351,212],"class_list":["post-72327","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-behavioral-health","tag-community-benefits-report","tag-heart-and-vascular-care-cardiovascular","tag-labor-delivery","tag-laboratory","tag-pain-care-and-management","tag-pregnancy-childbirth-and-newborn-care","tag-primary-care","tag-womens-care"],"acf":[],"yoast_head":"\nA maternal care desert: Providing health care in rural Craig, Colorado - 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