Crow women face long wait times, drives and confidentiality concerns when it comes to receiving reproductive healthcare. That’s according to a report from the Kaiser Family Foundation released Thursday.
If you’re a woman on the Crow Reservation trying to get prenatal care or an abortion, your only option might be a trip to a Billings provider. And your only option to get there might be to take the Crow Nation Transit bus from Crow Agency or Hardin.
"Gosh, the shuttle leaves at six in the morning," says Michelle Long, one of the Washington, D.C.-based researchers who worked on the Kaiser Family Foundation study. She says lack of transportation in a place that can be an hour drive from the nearest healthcare provider is just one of the challenges she found during her research on the Reservation this summer.
Most of the tribal nation is located in Big Horn County, an area that’s been federally-designated as medically underserved. The teen birth rate is the highest in the state, at 85 births per 1,000 people. That’s more than three times the state average. But there’s no facility on the reservation that provides labor and delivery services. Prenatal women are transferred to Billings for care after 30 weeks, according to the report.
The Indian Health Service provides a wide range of services at its hospital and two clinics on the Crow Reservation, including oral contraceptives and STI testing and treatment, but does not provide sterilization or abortion.
The report, which also studied four other medically underserved communities across the U.S., says understaffing at the IHS facilities and cultural attitudes towards sex and abortion are some of the factors barring access to reproductive healthcare.
"The clinics face challenges there with recruiting and retaining providers," says Long.
The report says that the Crow Agency IHS Service Unit employs one Ob-Gyn and one midwife for the community of about 7,000. It mentions turnover as a challenge and says IHS is in the process of building housing across the Service Unit to attract more talent.
IHS says it continues to recruit and hire qualified medical professionals who help enhance labor, delivery and gynecological services with the Crow Service Unit.
It says it’s exploring ways to expand labor and delivery services at the Crow Service Unit.
Long says focus group participants told her that culturally sensitive care is the most urgent need on the reservation.
Olivia Reingold is Yellowstone Public Radio’s Report for America corps member.