National Trend Occuring Locally

Recent headlines have sounded the alarm on a troubling national trend: early prenatal care is on the decline across the United States. While the national data is concerning, the situation in Manhattan, Kansas, and the surrounding Flint Hills region is shaped by a unique set of local circumstances.
The Fort Riley Hiring Freeze
The primary driver of this shift began on January 20, 2025, with a Department of Defense hiring freeze that remains in effect today. Because Fort Riley cannot hire civilian providers to replace those who leave or to restore staffing levels following last year’s cuts, they have been forced to prioritize care.
Currently, maternity services at Fort Riley are limited to active-duty service members. This shift has pushed military family members into the civilian healthcare system, creating an immediate strain on local resources.
In Manhattan, the civilian "safety net" is small. Women’s Health Group is the only OB practice serving the area and providing care at Via Christi Hospital. With the sudden influx of patients from Fort Riley, both the practice and the hospital are serving higher patient loads.
The results are visible in the scheduling:

• Delayed Physician Access: Most patients don't see an actual OB until they are 20 weeks or further into their pregnancy.
• Initial Triage: Early appointments are often handled by nurses or clinical staff rather than doctors, unless the pregnancy is flagged as high-risk.​

Unfortunately, this isn't a problem that can be solved overnight. Several systemic barriers stand in the way:

• The Physician Shortage: While hiring more OBs seems like the obvious answer, there is a nationwide shortage of specialists entering the field, making recruitment in rural or mid-sized markets incredibly competitive.
• Labor & Delivery Closures: As smaller regional hospitals continue to shut down their maternity wards, Manhattan becomes a "catch-all" for even more patients from outlying areas.
• Midwifery Limitations: In many states, midwives help bridge this gap. However, Kansas medical provider licensure remains a complex hurdle. Depending on whether a midwife is licensed through the Board of Nursing or the Board of Healing Arts, their scope of practice varies wildly. Furthermore, Kansas currently has no licensure path for Certified Professional Midwives (CPMs).

Looking AheadWith no end in sight for the federal hiring freeze and local caseloads continuing to climb, the window for early prenatal care may continue to shrink. For families in the Manhattan area, navigating pregnancy now requires more patience—and earlier planning—than ever before. For those interested in a home birth, contacting a midwife as soon as possible is vital since the area midwives do book up quickly. 

Sources:
https://www.shrm.org/topics-tools/news/talent-acquisition/trump-extends-federal-hiring-freeze-merit-based-eo
https://www.nbcnews.com/health/health-news/pregnant-women-delaying-prenatal-care-cdc-report-rcna259575
www.bartonassociates.com/blog/ob-gyn-employment-opportunities-market-trends-and-essential-faqs/