EVANSTON — A new Intermountain Health (IH) Maternal Health Connections (MHC) clinic opened its doors in Evanston on Friday, April 4. The Herald met with IH Grants Project Director Krystal Richards and IH Nurse Care Coordinator Courtney Bettinson, BSN-RN, to discuss the clinic’s inception and available services.

“It was an overnight need,” Richards said of Evanston Regional Hospital’s (ERH) announcement of its decision to discontinue gynecology and labor and delivery services last fall. “We heard essentially when the community heard ... We knew that there was lot of feedback from the community around concern and fear.”

By November, Richards had been contacted by numerous IH-affiliated parties because she had previously piloted two MHC clinics in Montana in 2023. Those clinics were funded through the Rural Maternity and Obstetrics Management Strategies (RMOMS) grant available from the federal agency Health Resources & Services Administration (HRSA). With leftover 2024 funding, the plan for an Evanston MHC started taking shape.

According to a recent WyoFile article, 11 of Wyoming’s 23 counties no longer offer practicing OB-GYNs. Citing timing and awareness, Richards admits it was a perfect confluence of events that allowed such an opportunity to unfold in Evanston, rather than in another of the state’s maternity deserts.

“We want to make this program more accessible and make it so patients can stay in their community for their care,” Richards said, hinting at possible future expansion efforts in Lincoln, Sublette, and western Sweetwater counties.

“They’ve (the clinics in Montana) been successful, and we’ve seen the benefits to the community and to the patients — it’s a feel-good program,” Richards said.  “From the responses we’ve gotten from patients, they don’t have to make a choice between taking off a full day of work for X amount of hours [to travel] for a 15-minute visit and being able to put food on their table since they’re not missing work or wages.”

“On average, they’re saving drive time for every visit,” Richards continued.  “Here, for instance, we know that’s going to be a 2 to 2.5 hours of [drive time] savings.”

Since late fall, IH has met with ERH regularly to outline clinic plans and lease an office space at the Uinta Medical Group building.

“They were very receptive to wanting the support,” Richards said. “They knew this was a need, and the fact that we had a solution for it was a welcomed one.”

Bettinson — a local and experienced registered nurse of 17 years, 13 of which were in the hospital’s labor and delivery/maternal and newborn care unit — came to IH’s attention with a letter of recommendation from ERH.

“It was icing on the cake that she’s absolutely amazing … in addition to the fact that we were able to utilize one of the staff members that was displaced,” Richards said.

“My heart and my passion lie with labor and delivery and maternal and newborn care,” Bettinson told the Herald. “In my eyes, this opportunity was just the perfect career choice. I couldn’t have asked for a better program to serve the community [where] I was born and raised.”

“I wanted to be part of the solution ... anything that I could do to help to make sure these moms and babies are getting the care they need,” Bettinson said.

Invested in her patients, she said, “Now I get them, potentially for their whole pregnancy and a whole year postpartum. I get to build a relationship and rapport with that patient and get to see their baby grow,” as opposed to just spending their birth day with them in the delivery room during her time with ERH.

The virtual and hands-on hybrid clinic, which is not a birthing center, is for month-to-month basic OBGYN check-ups, up to the due date. It also offers an array of maternal health care support before, during and after pregnancy.   

“We’re able to do non-stress tests and limited ultrasounds here, as well,” Bettinson said. Richards added that if a non-stress test result is concerning, a virtual maternal fetal medicine (MFN) team will be available to intervene immediately.

Regarding high-risk pregnancies, Richards outlined remote patient monitoring options.

“They get a blood pressure cuff, an O2 monitor, a scale, a thermometer, so we’re tracking those core vitals on a regular basis.”

Virtual hospital nurses, not Bettinson, are on-call to monitor those figures 24/7 remotely. “If something needs to be escalated [it will be] up to our MFN team,” Richards said.

As far as emergencies are concerned, patients are recommended to report to the ER at ERH.

“This isn’t an acute care clinic,” Bettinson said.

The clinic’s affiliated OB-GYN physicians are all in-house IH providers located on the Wasatch Front in Utah and must be licensed to practice in the state of Wyoming.

Nearly two weeks after opening, Bettinson reported that her first patients “are excited not to have to drive down to see their doctors ... or take time off work,” particularly moms-to-be who fatigue easily or have other, small children, she said.

“One thing of note, we’ve seen really good benefits up in Montana with the connection to mental health services,” Richards said of the program’s ability to facilitate connection to behavioral health services.

Patients can access telehealth services from home, particularly for postpartum depression, which can be accommodated urgently if necessary.

“We’re seeing EPDS (Edinburgh Postnatal Depression Scale) scores are going down and patients are appreciating the additional support,” Richards said.

She also highlighted the implementation of the Peripartum Addiction Treatment Healing (PATH) program which supports pregnant and postpartum individuals suffering from substance abuse disorders. 

Although the initial RMOMS grant runs out in August, Richards confirmed that the clinic’s status will not be impacted.

“I commend IH for making a commitment knowing this is the one time we can help stand it up ... and it has committed to continue funding the MHC here in Evanston regardless of the grant funding … for the foreseeable future.”

“I will pour my professional heart and soul into this program,” Bettinson said. “I’m really excited about it.”

In addition to Bettinson’s perinatal health and wellness support, other services available include: home health visits; mental health support; the PATH program for addiction-related issues; assistance with establishing care with an OB-GYN provider; lactation counseling, consultation and postpartum nursing support; remote patient monitoring (RPM), vital signs, symptom tracking support with a 24-hour emergency phone triage nurse support; Social Determinants of Health (SDOH) screening and assistance with insurance applications.

Virtual services include: car seat installation; genetic counseling, consultation and care; maternal fetal medicine care; and behavioral health with medication management including counseling.

All services are available as needed for patients enrolled in the program. The clinic is open twice weekly, from 8 a.m. to 5 p.m. The first week of every month, it’s open Monday and Friday. The remaining weeks of each month, it is open Wednesdays and Fridays. The clinic is located at the Uinta Medical Group, suite 7.