Editor’s Note: Colorado’s healthcare system is entering a period of accelerating instability — a “tsunami,” as multiple leaders describe it — driven by collapsing hospital finances, shrinking Medicaid reimbursements, disappearing services and a political fight over who is responsible for this unraveling. Healthcare Freefall is a multipart series examining how Colorado arrived at this moment, what H.R. 1 will do next and why communities across the state are bracing for deeper shocks.

When contractions started at 2 a.m. on a December morning in 2024, Molly Norton didn’t rush.

In a previous pregnancy, Norton had developed high blood pressure and was induced. Her labor progressed so quickly that just 45 minutes passed between her water breaking and her first son’s birth. She never actually experienced early labor. She and her husband returned home to Telluride with a healthy baby.

She made sure to tell her new OB-GYN team that her first baby had arrived extremely fast.

“The doctors told me that he came quickly because of the induction,” Norton said of her firstborn, Sunny.

Now pregnant again, she and her husband left their Telluride home two hours after the first contractions.

They made it only 20 minutes down the road. On a hill overlooking Ridgway, Henry was born. Paramedics arrived within minutes and took Norton and her newborn to Montrose Regional Health.

In both her pregnancies, Norton faced a familiar dilemma — the nearest labor and delivery options were all far from home: 1.5 hours to Montrose, two hours to Durango or two-and-a-half hours to Grand Junction.

For many women in rural Colorado, pregnancy begins with a simple but daunting calculation: how far they’ll have to travel for prenatal care and a safe place to give birth.

Norton’s journey to motherhood had already been shaped by loss. After several miscarriages and feeling unsupported by her OB-GYN in Montrose, she had switched to a provider in Durango when she became pregnant with Sunny, her first son. That meant months of two-hour drives, alone, on mountain roads.

“My husband didn’t have a job that was flexible,” she said. “Making the drive by myself got old really fast.”

By 2024, pregnant again, Norton knew Durango was no longer realistic. She had started a new job at Telluride Ski Resort and couldn’t spend full days traveling for appointments. Friends and neighbors were reporting good experiences with a new provider in Montrose, so she made the switch.

“A part of me is embarrassed,” she said after giving birth on the road. “If I had known, or had an indication, that it was going to be that fast, I would have gone to the ER in Telluride. In hindsight, I don’t understand why it was downplayed so much — that my oldest was born so quickly. It clearly wasn’t the induction.”

People across the country face economic barriers to healthcare, but in rural communities those challenges are intensified by distance.

“What we are seeing in women’s health is access to the service being an issue,” said Chris Hall, CEO of Remote Area Medical, a nonprofit that provides free healthcare clinics nationwide. “Whether that’s geographic or cost, barriers to healthcare create issues. We’ve seen patients putting off care because they have to pay their mortgage. They sacrifice their healthcare to live life.”

Remote Area Medical is a nonprofit that delivers healthcare in locations nationwide, including with its fleet of mobile clinics. (Photo: Courtesy of Remote Area Medical)

Hall said Remote Area Medical (RAM) has seen more patients with some form of insurance since 2012, but coverage doesn’t guarantee access.

“There are still barriers,” he said. “We’ve seen that there’s no difference in the ability to access care between states that have expanded Medicaid coverage and those that haven’t.”

RAM offers dental, vision and medical services, along with pap smears and mammograms. Patients often travel from other states to reach a clinic. At a recent event in Knoxville, Tenn., patients came from 11 states.

That pattern is familiar to Dr. Shannon Miller, an OB-GYN at St. Mary’s Hospital in Grand Junction. As of 2026, one in four labor and delivery patients travel from outside Mesa County.

“Mesa County covers a huge area, and a large amount of our patients are traveling 45 minutes plus to reach us,” Miller said. “I counsel patients to take that into consideration. Any concerns you have during your pregnancy, you have to account for the drive time.”

Winter added another layer of uncertainty, with mountain passes often hazardous or closed.

“Across the country, it’s harder to get evaluated by a specialist,” Miller said. “And in rural areas, there are just fewer doctors.”

Colorado has seen multiple labor and delivery closures in recent years.

Memorial Regional Health in Craig closed its ward in 2020. Delta Health and Rangely District Hospital followed in 2025, citing provider shortages, financial strain and declining birth rates.

Nationally, more than 293 rural hospitals have stopped providing obstetrics since 2011, and another 200 have closed entirely. A study by The Chartis Center for Rural Health found that 46% of rural hospitals operate at a loss, and 432 are vulnerable to closure — affecting more than 46 million rural residents.

The study warned of expanding care “deserts” for essential services like obstetrics and chemotherapy. In Colorado, between 21% and 30% of rural hospitals have stopped offering OB care since 2011.

To help bridge the gap, St. Mary’s expanded virtual appointments for low-risk pregnancies and reserves prenatal slots for new patients. The hospital is the only specialist center serving eastern Utah and the Western Slope of Colorado, with a Level 3 NICU, a full OB-GYN team, 24/7 anesthesia and a strong midwifery program.

“Rural areas don’t have access to the same resources,” Miller said. “While rural healthcare providers help out with prenatal care, we do see patients who have to change providers at a late stage when they become high risk.”

For families, months of long drives mean financial strain — gas costs, missed work and childcare challenges. Some patients relocate to Grand Junction for the final weeks of pregnancy, often paying steep prices for short-term housing.

“My pie-in-the-sky dream would be to have all our healthcare facilitated here, nearby,” Norton, the Telluride mother, said. “There’s no reason that can’t be done here, in Telluride. It would be ideal to cut out those drives for simple, 15-minute checkups. And I wish I had been better educated, or prepared, or my medical team would have given more consideration to my history.”

Read more from the Healthcare freefall series:

Longer drives, fewer options for maternity care in Colorado

Telluride mother’s roadside birth underscores shrinking access to OB care in Colorado

Breast cancer survivor shares strain of rural treatment travel

Once built on federal investment, rural hospitals today fight to survive

Subsidy cuts, insurance gaps reshape how Coloradans will seek care

Finger‑pointing intensifies as Colorado’s healthcare system strains under rising costs, shrinking coverage