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(Wyoming News Service) Wyoming ranks 42nd in the U.S. for women's health and reproductive care, according to a new report - and some are urging lawmakers to make changes.

According to a new state scorecard from the Commonwealth Fund, Wyoming ranks among the bottom 10 states on multiple indicators for women's health care.

The state is especially low for rates of preventive measures, including cervical and breast cancer screenings and routine checkups.

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Rates of maternal deaths and infant mortalities in Wyoming are on par with national averages - but the state's birth rate is going down.

Rebekah Hazelton, director of the Wyoming Women's Foundation, said that's been hard on rural hospitals.

"Those small maternity care centers are not really receiving enough births in their care," said Hazelton, "in order to keep up their core competencies, and have enough staff as well."

Hazelton said that makes it economically challenging for hospitals to provide maternal health services. There were just over 6,000 births in Wyoming in 2022 - a 20 percent decrease from 2012.

Another low score is on women's health coverage, access and affordability.

Hazelton said access to specialists can be minimal in a rural state. And then there's health coverage - Wyoming is one of only ten states that hasn't yet expanded Medicaid.

"That leaves a significant amount of the population in the gap," said Hazelton, "not able to pay for health care out of pocket and not able to access health insurance."

Hazelton said she hopes the Health and Labor interim committee discusses potential solutions at its upcoming meeting - including training and certifying more nurse-midwives, and improving relations between hospitals, lay-midwives, and doulas.