Mothers in North Idaho currently face many obstacles when it comes to accessing maternity care, particularly in rural areas. A shortage of birth centers, a decline in OB/GYNs, and high out-of-pocket birth costs all increase financial strain, stress and health risks for mothers.

Options for maternity care services in North Idaho have narrowed since Bonner General Health in Sandpoint closed its labor and delivery department in 2023.

“For patients, that can mean longer travel distances, longer waits for appointments and fewer choices when seeking specialty care,” the Bonner General Health leadership team said.

Idaho has one of the lowest rates of OB/GYNs proportional to its population. In 2023, the Idaho Department of Labor ranked Idaho 47th in the country, with a ratio of 9.4 per 100,000 population, 50% lower than the national average of 14.5 per 100,000.

The state of maternity care has worsened since Idaho lost 94 of its 268 OB-GYNs (35%) between 2022 and 2024, according to a JAMA Network study titled “Change in Number of OB/GYN Physicians Practicing Obstetrics After the Dobbs Decision.” Since the overturn of Roe v. Wade in 2022, OB/GYNs have had to navigate changing laws around their practices.

“The concern is that physicians may face uncertainty about how certain medical decisions will be interpreted under Idaho law,” reported the Bonner General leadership team, “which can make recruiting and retaining OB/GYNs more challenging throughout the state.”

Data from a 2023 report on maternity care in Idaho by the March of Dimes reported that 19.7% of women had no birthing hospital within a 30-minute drive, compared to the national average of 9.7%. The situation has worsened as three hospitals in Idaho closed their birthing centers in the last three years, including Bonner General, citing low patient volume and difficulty recruiting physicians due to Idaho’s changing legal climate around OB/GYN services.

Mothers in the Sandpoint area must now travel farther to cities like Coeur d’Alene to seek care, and Kootenai Health CNO Kim Jorgensen anticipates increased demand for OB/GYNs at Kootenai.

“We have seen an increase in patients traveling from farther north to seek maternity and obstetric care at Kootenai Health,” said Jorgensen. “Our birth volumes have increased year over year.”

Meanwhile, many patients in North Idaho are crossing the state line to receive maternity care. When Bonner General closed its labor and delivery services, Newport Hospital in Washington was overwhelmed by demand from displaced Bonner General patients.

“With no obstetrical services in the immediate Idaho region, many Idaho families come to Newport for care,” said Newport Hospital spokesperson Jenny Smith. “When Bonner General Health closed its obstetrics department in Sandpoint, Newport Community Hospital's labor and delivery unit was temporarily closed because of staffing constraints.”

As North Idaho mothers face a shortage of birthing centers and longer travel times, licensed midwife Ginger Cullen at Full Moon Midwifery in Coeur d’Alene reports that she has seen an increase in patients seeking out-of-hospital care in the last few years.

Midwifery practices like Full Moon provide another option for women with low-risk pregnancies, with the added benefit that the midwife can travel to the patient’s home rather than the patient traveling to a hospital.

“We can go to them rather than them having to drive one and a half hours to Kootenai,” Cullen said.

Another reason for patients seeking alternative maternity care are high out-of-pocket costs of giving birth. A MoneyGeek report from 2020 titled “Average Cost of Having a Baby in the US” ranked Idaho as having the eighth-highest birth costs in the country, with an average birth in Idaho costing $2,435 out-of-pocket. Costs are much higher for patients without insurance, and midwifery practices offer a cheaper alternative for uninsured mothers.

“We are seeing a lot of people who are low on the socioeconomic profile,” Cullen said.

However, midwives are only qualified to handle low-risk pregnancies and cannot perform emergency C-sections. Hospital birth centers are necessary for high-risk pregnancies, which is why reduced access to birthing centers puts North Idaho mothers at risk.